Category: Revenue Cycle Management

Five Healthcare Trends To Note In 2023

Five Healthcare Trends To Note In 2023

The leaders’ guide on what’s shaping the industry. Now is the time for decisive action and visionary leadership as the healthcare industry moves past the urgency of the pandemic—which forever changed care delivery and the workforce—to opportunities that will create a more patient-centric and sustainable healthcare system. That takes a watchful eye from leaders on […]
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Six Steps to Prevent Readmission Denials

Six Steps to Prevent Readmission Denials

Prevention of readmission denials improves case mix index (CMI), reimbursement, and quality metrics. As a consultant, I am like the FBI – if you invite me in, I will likely take your case. This often leads to varied and challenging projects. Often, I am engaged to assess opportunity in provider documentation, clinical documentation integrity (CDI) […]
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Practical Tips For Reducing Claims Denials

Practical Tips For Reducing Claims Denials

Medical claims denials are on the rise and continue to be a costly problem for health systems. Unfortunately, the vast majority of providers focus their resources on reactive responses, working to appeal denials and recover payments after denials have already occurred. In a Becker’s Healthcare podcast an expert, discussed the problem of rising denials, why […]
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CMS Aims To Streamline Prior Authorization To Reform MA

CMS Aims To Streamline Prior Authorization To Reform MA

The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA). In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing. The Biden administration has shown a commitment to increasing oversight of […]
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EHR-RCM Integration Can Improve Revenue Cycle Efficiency

EHR-RCM Integration Can Improve Revenue Cycle Efficiency

Partnering with a vendor that provides EHR and RCM capabilities helped one healthcare organization boost communication and improve revenue cycle efficiency for 150 care centers. Leveraging automation for revenue cycle management (RCM) processes can streamline tasks and improve efficiencies. Specifically, partnering with an EHR vendor helped a healthcare organization to achieve $1 billion in patient […]
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