Category: Revenue Cycle Management

From Cost Savings to Revenue Growth: How Outsourcing RCM Benefits Providers?

From Cost Savings to Revenue Growth: How Outsourcing RCM Benefits Providers?

Prompt payment to healthcare providers for their services is crucial for a detailed discussion on managing macro costs, quality, and equity. Without it, addressing the issue of rising healthcare costs becomes challenging. Healthcare providers are well aware that getting paid is not an easy task. A quick search for revenue cycle management (RCM) reveals 16-step […]
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Top 7 Revenue Cycle Management Technologies for Providers

Top 7 Revenue Cycle Management Technologies for Providers

Revenue cycle technology comes in various forms, tailored to the specific needs of healthcare providers, yet these indispensable tools have become vital for ensuring seamless operations within the revenue cycle. The healthcare revenue cycle represents a vast and intricate operation that encompasses a range of activities, from patient registration and insurance verification to denials management […]
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Prior Authorization in Medicare Advantage : Lawmakers Call for Streamlined Process

CMS has proposed a rule to simplify prior authorization in government-sponsored health insurance programs. However, some lawmakers are urging the agency to do more. A bipartisan coalition of 233 representatives and 61 senators have written a letter to CMS requesting that the proposed rules be expanded and that the changes be finalized quickly to enhance […]
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The High Costs of Delaying AI Adoption in Revenue Cycle Management

The prominent role of AI in healthcare is hard to ignore. In recent years, significant advancements have been witnessed in the field of revenue cycle management (RCM), particularly in coding and billing. The emergence of new technologies incorporating natural language processing, deep learning, and other cutting-edge techniques has revolutionized the process, surpassing the limitations of […]
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Denial Management and Strategies to Reduce Claim Denials

Denial Management and Strategies to Reduce Claim Denials

Denial management is a critical process in the healthcare industry that involves identifying, analyzing, and resolving claim denials. Claim denials occur when healthcare providers’ reimbursement requests are rejected by insurance companies due to various reasons. These denials can have a significant impact on providers’ revenue and overall financial health. In this blog post, we will […]
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The Impact and Challenges of Medicare Advantage for Payers and Providers

The Impact and Challenges of Medicare Advantage for Payers and Providers

Medicare Advantage (MA) is becoming more appealing to payers due to its numerous benefits, but providers are struggling to adjust to its effects. Payers are increasingly recognizing the advantages of MA, especially in terms of profitability. According to a study conducted by the Kaiser Family Foundation (KFF), MA insurers disclosed an average gross margin of […]
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