Tag: Denial Management Services

Enhancing Claims Management: Identifying Errors, Maximizing Efficiency, and Streamlining Operations

Enhancing Claims Management: Identifying Errors, Maximizing Efficiency, and Streamlining Operations

Claims management serves as a valuable tool for insurance firms, enabling them to identify the root causes of claim errors, measure areas for improvement, and explore new opportunities to continuously enhance their operations. However, the ever-increasing complexity of claims administration poses a formidable challenge for insurance businesses, hindering their ability to uncover fresh prospects and […]
Learn More
CMS Prior Authorization—operational And Financial Impact

CMS Prior Authorization—operational And Financial Impact

CMS has expanded the prior authorization requirement to two new service categories within hospital outpatient department services. The Centers for Medicare & Medicaid Services (CMS) has expanded the prior authorization requirement for two additional hospital outpatient department (OPD) services. Effective with date of service July 1, 2021, CMS has expanded the prior authorization requirement to […]
Learn More
Medicare Advantage Plan Denials

Medicare Advantage Plan Denials: Is That Convoluted or What?

Medicare Advantage Plan contracts are “take-it-or-leave-it” agreements Many questions are swirling about regarding Medicare Advantage Plan (MAP) denials asking what to do about the increasing number and given reasons.  I’ve heard or read some amazing stories where payers have gone to astounding lengths to deny claims.  Answers are also swirling about based on understandings of […]
Learn More
10 Revenue Cycle Tips For Healthcare Organizations

10 Revenue Cycle Tips For Healthcare Organizations

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 […]
Learn More
Steps to improve RCM

Eight Steps To Improve Revenue Cycle Efficiency

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 […]
Learn More
x