The prominent role of AI in healthcare is hard to ignore. In recent years, significant advancements have been witnessed in the field of revenue cycle management (RCM), particularly in coding and billing. The emergence of new technologies incorporating natural language processing, deep learning, and other cutting-edge techniques has revolutionized the process, surpassing the limitations of […]
A survey conducted by leading healthcare technology company, revealed the top revenue cycle tasks like denials management, coding, and prior authorizations requiring the most subject matter expertise. Out of 15 tasks listed, over 550 healthcares financial and revenue cycle leaders identified denials management, coding, and prior authorizations as the top choices. Denials management was chosen […]
Despite ongoing concerns about denials and beneficiary access to care, Medicare Advantage (MA) companies remain in the spotlight as their market penetration continues to grow. In April 2022, a report from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) highlighted a significant issue in the capitated payment model employed […]
In the intricate dance of healthcare administration, few steps are as frustrating and resource-intensive as denials management. Every rejected claim represents lost revenue, increased administrative burden, and potentially delayed or denied care for patients. In today’s challenging healthcare landscape, marked by shrinking margins and increasing regulatory complexities, a proactive and efficient approach to denials management […]
Ensure you make a well-informed choice when selecting a company to manage your reimbursements. Physicians seeking to improve their reimbursement rates, financial performance, operational efficiency, or focus on patient care should consider outsourcing their billing needs. However, choosing the right physician billing service for your practice can be a challenging task, as not all services […]
Having been on the receiving end of audits, and also having been an individual who has conducted them, I know the mindset from both sides of this equation. The one element to this equation that has changed over time is the increase in payer denials: those that are now clinical- and coding-focused, often resulting in […]
Revenue cycle leaders were asked to rank the most time-consuming tasks at their organization, and the results aren’t surprising. 556 chief financial officers and revenue cycle leaders at hospitals and health systems across the United States were asked to rank the most time-consuming revenue cycle tasks at their organizations in a new survey commissioned by […]
Two letters. They’re enough to give your patients more anxiety than any treatment, test or injection. A recent survey by the Pew Research Center shows it: Sixty percent of Americans said they would be uncomfortable with their provider relying on artificial intelligence (AI) in their own health care. But when used responsibly, artificial intelligence can […]
How do you resolve a repeated and shooting up problem like claims denials? It’s been a fresher subject for revenue cycle management professionals for years that are only experiencing hotter with the growing pressures of staffing shortages, troubles with staff movement and instructing and developing policies and protocols at the government and payer levels. On […]
Denial rates serve as a barometer for the financial well-being of healthcare organizations. An increase in denials can have wide-ranging negative implications for an organization — impacting everything from accounts receivable to the patient experience. By preventing denials upfront, providers can realize revenue faster, boost staff efficiency and satisfaction, and reduce patient anxiety related to […]