Improving clinical documentation quality, leveraging technology, and educating providers are key ways hospitals improve medical coding compliance in a value-based world. Medical coders are typically behind the scenes of patient care, analyzing records, selecting codes for billing, and managing patient data. But to a revenue cycle expert with over 20 years of coding experience at […]
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 […]
If You’re Not in the Lead, You’re Falling Behind. A survey conducted in July of last year found that less than half of providers are using commercial automated claims denial management systems. Considering that denials are on the rise, any organization that isn’t actively working on this issue is jeopardizing their bottom line. In fact, as value-based-care […]