The COVID-19 pandemic has proven that fast, meaningful change is both possible and necessary for healthcare revenue cycles to keep up with a changing world. But to make truly meaningful change within the revenue cycle, the industry will need to embrace even more changes, such as payer partnerships, greater automation, and standardization across payers. Payer-provider […]
Healthcare is the industry most at-risk during the coronavirus (COVID-19) pandemic. Providers are on the front lines of response efforts. At the same time, the financial implications of the pandemic are also creating significant revenue cycle challenges, putting providers even more at risk during the pandemic. Individuals are postponing non-emergency care for many reasons, from […]
Claims denials can be frustrating for a physician practice to deal with, but leaving them unattended leaves a significant amount of revenue uncollected, says Andria Jacobs, RN, CPHQ, chief operating officer at PCG Software. Her company develops healthcare applications focused on cost containment, fraud and abuse detection, based in Las Vegas, Nev. Jacobs says that […]
Contactless payments were on the rise even before COVID-19 hit. But now, health systems should see them as essential. Consumers are increasingly wary of touching a credit card terminal that others have used, a perfect conduit for spreading germs. For consumers, text payments serve as a convenient contactless way to pay, but there are other unique benefits […]
Northwell Health executives share practical, in-depth strategies to help revenue cycle leaders prepare for additional COVID-19 surges and other emergencies. Health system leaders around the country can look to systems like Northwell Health in New York for guidance about how to best prepare their own revenue cycles for a possible second wave of COVID-19 cases as states ease restrictions […]
Our goal was to develop a single source of truth that is user-friendly, dynamic, and easily accessible,” said Jeannette Wood, vice president of revenue cycle management for Privia Health. A rapidly changing situation like the COVID-19 pandemic calls for a dynamic solution for tracking billing and coding changes for virtual services from different payers across […]
Financial indicators, staffing, and leadership are three key factors emergency departments should prioritize for effective revenue cycle management during the COVID-19 crisis. At the start of the year, emergency departments (EDs) across the country began to prepare for an expected surge of patients infected with COVID-19, altering revenue cycle management and operational strategies. By March, […]
The early eruption of the coronavirus prompted the federal government to urge a widespread halt of elective procedures in hopes of slowing the viral spread. For radiologists, this caused a massive decline in routine exams, which can result in a 40 percent-to-60 percent loss in revenue. Evolving health policies and industry environments keep revenue cycle […]
Prior authorizations, or prior approvals, are strategies that payers use to control costs and ensure their members only receive medically necessary care. The cost-control process requires providers to acquire advance approval from payers before delivering specific services or items for a patient. Payers are increasingly using prior authorizations to lower their costs and improve care […]
The clock is ticking, and you’re trying to select the right E/M level from a drop-down menu in the EHR. Choose a level that’s too high, and you run the risk of post-payment audits and recoupments. Choose one that’s too low, and you may lose revenue to which you’re entitled. You decide to just trust […]