Tag: Revenue Cycle

Administrative-Policies-Overburdening-Providers

Administrative Policies Are Overburdening Providers

Some commercial health insurers are using policies that can delay patient care and create burden for providers, causing relationships with hospitals to worsen, according to a survey by AHA. The association fielded responses from more than 200 hospitals in 2019 and from 772 hospitals between December 2021 and February 2022, creating data that both predates […]
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AMA says health insurance industry failing on prior auth reform

Survey shows little progress after four years of promises The American Medical Association says that despite insurance industry promises to reform and improve prior authorizations, little effort has been made to do so. This comes despite evidence that insurer-imposed authorizations can be hazardous and burdensome to patient-centered care. In January 2018, the AMA and other […]
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Focus on unnecessary medical necessity denials

A focus on front-end revenue cycle efficiency can help to avoid costly medical necessity denials. KEY TAKEAWAYS Four words often describe the efforts to prevent denials related to medical necessity: too little, too late. Mistakes are made early in the patient’s hospital stay, and these mistakes lead to problems down the road. What remains constant […]
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How 5 Steps For Transforming Patient Access Saved $20M

‘If you can get it right up front, you’re ensuring accuracy, preventing rework, and preventing denials,’ says Alicia Auman, director of patient access at KSB Hospital. Patient access plays a tremendously important role within the revenue cycle, which is why Alicia Auman, director of patient access at KSB Hospital in Dixon, Illinois, has worked so […]
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Patient Payments Trends To Watch

Device agnostic digital patient intake; buy now, pay later; compassionate billing; and AI-enabled customizable payment plans are four trends that rev cycle leaders should watch as the pandemic rages on. Despite promises of a “hot-vaxxed summer,” the COVID-19 pandemic is raging on, more forcefully in some places than ever before. It’s also continuing to take […]
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3 Issues Revenue Cycle Leaders Will Have To Battle In 2020

First hand experiences from the country’s most innovative revenue cycles will be shared next month in West Palm Beach, Florida. What issues keep revenue cycle executives up at night? As the HealthLeaders’ revenue cycle editor, I will moderate discussions and hear firsthand experiences of successes, challenges, and the latest ideas coming out of the country’s most innovative […]
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2020 Outpatient Proposals: 5 Rules You Should Know From CMS

Hospital and health system executives should monitor these proposals for provisions that will affect their organizations’ operations. The 2020 annual rule cycle has been active for CMS. Several proposals in the outpatient prospective payment system (OPPS) proposed rule is controversial, although there is at least one provider-friendly change. Here’s a roundup of five regulatory rules […]
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What Patients Want During Online Appointment Scheduling? To Not Talk To Anyone

Patients prefer online scheduling to talking on the phone, a new report shows. Patients would rather make their healthcare appointments online without speaking to anyone, a new report reveals. However, the report doesn’t address how such a model might impact revenue cycles that want to do pre-service insurance verification and collections. The report, from the […]
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  • March 20, 2019

4 Ways to Stop Losing Patients Over Medical Bills

Every business not only wants to attract new customers but to keep its existing ones, and hospitals and health systems are no different. Unfortunately, surprise medical bills can be the element that drives patients away from one hospital and into the waiting arms of the competition. New research published this month in Health Affairs provides hospitals with […]
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  • February 19, 2019

AHIMA Coding Productivity Study and Preparing for ICD-11

Planning is underway now for ICD-11. The American Health Information Management Association (AHIMA) has been getting involved in the development of ICD-11 through its participation in the World Health Organization’s (WHO’s) activities, as well as providing members with high-level overviews of what to expect with the new classification system. ICD-11 has yet to be approved […]
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