Recently proposed rules would boost FY 2020 Medicare payment rates for several post-acute providers, including skilled nursing facilities and hospices. April showers bring May flowers. But, this year, they are also bringing a slew of new Medicare payment rate proposals, including reimbursement and quality reporting updates for several types of post-acute care providers. CMS recently […]
Denied claims are one of physicians’ chief complaints when it comes to dealing with payers. To a certain extent, every practice deals with claim denials. It’s those practices that eliminate the most common reasons that experience a smoother revenue cycle and find greater financial success. News Brief A capitation payment model results in better value […]
The U.S. healthcare industry has a $1 trillion opportunity to cut costs and reduce waste, according to a 2015 Harvard Business Review analysis. While there are various areas waste accumulates, costly data reconciliation is a prominent problem for hospitals and health systems. Change Healthcare defines data reconciliation as “the process of compiling information across companies […]
By now, these medical payment denial statistics are old news: • 50-65% of denied claims are never reworked • 200 million claims are rejected every year • 90% of denials are avoidable Although these numbers are common and, most likely, first-hand knowledge among providers, they continue to frustrate medical practices year after year. That’s why […]
Merging front and backend functions, leveraging data, collecting payments upfront, and automating prior authorizations are key to healthcare revenue cycle management excellence. “There is always room for improvement” should be healthcare revenue cycle management’s mantra. Declining claims reimbursement rates, the shift to value-based purchasing, and evolving health policies keep revenue cycle leaders constantly seeking new […]
Even as recently as five years ago, the revenue cycle outsourcing process took on a very different form to that of today. For years, most organizations saw the revenue cycle as little more than a cost center – meaning that revenue cycle outsourcing was a decision made largely from an administrative perspective. It was seen […]
As patients take on more out-of-pocket costs, and patient satisfaction continues to influence the financial health of hospitals, revenue cycle management has become increasingly important to organizations. Amid these and other changes, many revenue cycle professionals have offered thought-provoking insights. Here are 10 RCM tips from industry experts: 1. “To make sure that your organization […]
Revenue cycle management refers to the business side of your practice—from verifying patient insurance eligibility to submitting claims to receive health plan payments and billing patients for their share of service costs. Although patient care will always be your top passion and priority, an efficient revenue management system is critical for your practice’s financial health […]