In 2024, factors like declining reimbursement rates, the shift towards value-based care, and ever-changing regulations demand a proactive approach to improve RCM. Here, we explore four key strategies to optimize your healthcare revenue cycle and ensure financial stability in the coming year. 1. Break down Silos: Merging Front-End and Back-End Functions Many healthcare organizations struggle […]
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. […]
Claims Denial: Healthcare Leaders report an increase in payer denials, putting increasing pressure on the system’s finances. Going back and forth with denied payers is a long and expensive process, and low reimbursement rates don’t help either. In a new survey conducted by the Healthcare Financial Management Association, CFOs noted a significant increase in denials, […]
Medical Billing Myths: Medical billing is an important part of the complicated world of healthcare management. However, many practice owners struggle to negotiate the complexities of medical billing. Myths and misconceptions about medical billing can exacerbate problems, resulting in financial losses and administrative headaches. To help keep you educated and empowered, we’ve developed a list […]
Optimizing revenue cycle management is crucial for recovering from the significant losses of the previous year. Leading provider organizations have developed three effective strategies to address this challenge. In the wake of the COVID-19 pandemic, fine-tuning revenue cycle management has become a priority for financial leaders. Last year, healthcare institutions faced substantial declines in revenue […]
Denial rates, notably within Medicare Advantage, are on the rise, impacting both hospital revenue cycles and patient care, remarked the executive director of a Minnesota-based large multispecialty health care organization focused on Revenue Cycle management. Despite the organization reporting a favorable margin this year, it falls short in achieving profits comparable to those of insurers, […]
Revenue cycle management (RCM) is an intricate and critical aspect of the healthcare industry, encompassing the entire process from patient registration to reimbursement. However, RCM processes often face challenges, leading to pain points that can hinder efficiency, increase costs, and negatively impact patient satisfaction. Outsourcing Revenue cycle management services offers a viable solution to alleviate […]
Key Performance Indicators (KPIs) within the healthcare revenue cycle play a vital role in monitoring financial well-being and optimizing revenue capture for providers. Understanding these metrics is crucial for healthcare organizations aiming to sustain access to high-quality, cost-effective care—an essential aspect of the evolving landscape of value-based care and healthcare consumerism. These KPIs offer critical […]
A survey revealed that healthcare organizations anticipate that autonomous coding will accelerate the revenue cycle process and enhance coding accuracy. Although autonomous coding has the potential to streamline revenue cycle processes and alleviate administrative burdens, a majority of healthcare finance leaders surveyed either lack familiarity with it or harbor reservations about fully trusting this automated […]
Ensuring effective denial management continues to be the foremost concern for revenue cycle leaders, emphasizing the increasing demand for streamlined processes and vigilant oversight. Over the recent months, there has been a notable surge in challenges related to denials management, presenting a multifaceted and costly issue for revenue cycle leaders. Seeking Cost-Effective Solutions? Explore the […]