Tag: RCM Services

Unlocking Revenue Growth: Data-Driven Strategies for RCM Optimization

Unlocking Revenue Growth: Data-Driven Strategies for RCM Optimization

RCM optimization: While maximizing revenue is paramount in today’s competitive business environment, many organizations experience inefficiencies in their RCM processes. Here’s where data becomes your secret weapon. With data-driven strategies, you can maximize your revenue cycle management (RCM), unlock revenue potential, and grow significantly. Understanding RCM and its Impact on Revenue In Revenue Cycle Management […]

Unlocking the Secrets of Denied Claims: Insights, Solutions, and Strategies

The Prime Minister’s recent voluntary national survey shed light on the Denied claims. The survey, conducted between October and December 2023, found that nearly 15% of all Medicare Advantage, Medicaid, Commercial and Managed Medicaid claims were denied. Between 45% and 60% of rejected cases were overturned, although the expensive appeals process sometimes meant multiple appeals. […]
Stop Authorization Denials in Tracks

Stop Authorization Denials in Tracks

Getting bogged down by authorization denials? You’re not alone. Here, we explore common roadblocks and effective strategies to keep your revenue flowing smoothly. Challenge: Drowning in Last-Minute Authorizations Solution: Divide and Conquer with a Multi-Team Approach Separate teams can tackle present and future authorizations. The “Today” team verifies benefits and identifies authorization needs for upcoming […]
Boost Revenue & Reduce Denials: Expert RCM for Healthcare Providers

Boost Revenue & Reduce Denials: Expert RCM for Healthcare Providers

RCM Company has been at the cutting edge of making a difference in healing centers and wellbeing frameworks addressing patient-involved (coordination of benefits) and clinical dissents, recouping on low-balance accounts, and resolving complex claims. Getting these ranges of the income cycle settled rapidly and effectively is becoming tall need these days, as healthcare providers confront […]
Power of Healthcare Revenue Cycle Management in 2024

Power of Healthcare Revenue Cycle Management in 2024

In the intricate realm of healthcare, where patient well-being is closely entwined with administrative complexities, the cornerstones of success lie in effective revenue management and specialized revenue cycle management services. This pivotal link between clinical operations and financial viability is established through the practice of healthcare revenue cycle management (RCM) and services offered by specialized […]
5 Benefits of Addressing Payment Integrity Before Payments Are Ever Made

5 Benefits of Addressing Payment Integrity Before Payments Are Ever Made

Payment integrity in Medicaid—the concerted effort to keep tight control over fraud, waste and abuse—can be addressed at any stage in the claim cycle. Of course, the earlier it is addressed, the easier it is for health plans to avoid improper payments and the administrative burden of recovering them. And while pre-payment integrity programs maximize […]
Medicare advantage prior authorizations are often unnecessarily denied

Medicare advantage prior authorizations are often unnecessarily denied

  A report by the Office of Inspector General (OIG) raises concerns about organizations prioritizing profits over patient access to care. Medicare Advantage organizations (MAOs) often delay or deny services for medically necessary care, even when prior authorization requests meet coverage rules, according to a report by the OIG. A concern with the Medicare Advantage […]
AMA Urges Congress to Update Medicare Physician Payment System

AMA Urges Congress to Update Medicare Physician Payment System

The American Medical Association urged congressional leaders to lift the freeze on Medicare physician payments and provide updates that reflect inflation and practice costs. Following a recent Medicare Payment Advisory Commission (MedPAC) report, the American Medical Association (AMA) has asked Congress to update the Medicare physician payment system to include a stable annual payment rate […]
Healthcare Tech Company Launches Online Price Transparency Tool

Healthcare Tech Company Launches Online Price Transparency Tool

Through the online price transparency tool, users can view hospital service prices and assess machine-readable file completeness. A healthcare technology company has launched an online price transparency tool that allows consumers to compare hospital costs before seeking care. Turquoise Health’s Price Transparency Scorecard lets consumers find prices by searching for specific services or providers. The […]