Category: Blog

3-strategies-for-revenue-cycle-management-optimization

3 Strategies for Revenue Cycle Management Optimization

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 […]
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10 Prior Authorization Updates in 2023 

In 2023, multiple entities, such as the Health Insurance Company and health Services Company, declared reductions in prior authorizations. Healthcare Media provided further details on this and additional updates related to prior authorizations in the healthcare sector reported this year. According to a November 13 report from the Medical Group Management Association, 89% of medical […]
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transformative-impact-of-RCM-Software-in-revolutionizing-healthcare

How Revenue Cycle Management Software Reshapes Healthcare in 2024

Understanding the complexities of healthcare finance can resemble untangling a sophisticated puzzle. Every billing and coding intricacy holds the potential to influence patient care delivery. Recognizing this significance is key, and that’s precisely where the game-changing influence of revenue cycle management software becomes evident. Your worry might revolve around the potential financial stress on healthcare […]
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Surprise-Billing-Dispute-Resolution

Surprise Billing Dispute Resolution: Challenges, Lawsuits, and Proposed Changes

This year, the CMS has frequently halted and resumed arbitration due to court cases causing disruptions in the regulatory process aimed at settling surprise billing disputes. Summary Overview: Last Friday, the CMS finalized its revamp of the No Surprises Act resolution process, fully reopening the portal for resolving disputes, including batched and single disputes for […]
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Top 3 Critical Challenges for Revenue Cycle Leaders in 2024

 As we approach the end of 2023 and the holiday season draws near, revenue cycle leaders ought to contemplate including these three challenges in their organization’s roster of New Year’s resolutions. Automating Payer Processes: Similar to healthcare organizations, payers have also started embracing automated solutions, intensifying challenges in managing denials and causing delays in payment […]
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Christmas -ICD-10 injury codes

ICD-10 Codes to Ring the Bell on Christmas Season

December is the Christmas, a holiday season, it’s the right time to decorate, indulge in tasty treats, and gather with loved ones. It’s known to us that all the festive celebration brings the risk of injuries and illness. Note down these ICD-10 codes for the christmas season, which will help physicians to diagnose emergency rooms, […]
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Evolution of Recovery Audit Contractor (RAC) Audits: Challenges, Changes, and Current Landscape

The inception of Recovery Audit Contractor (RAC) audits dates back to 2005, reaching their zenith around 2010 before encountering a deceleration amidst the COVID-19 period. In 2006, Congress granted the Centers for Medicare & Medicaid Services (CMS) the authority to launch the Recovery Audit Contractor program across three initial states: New York, Florida, and California. […]
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Impacts of Claim Denials on Revenue Cycle

How Claim Denials and Payer Audits Impacts Healthcare Revenue Cycle

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, […]
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The Future of Healthcare: 4 Tech Trends Shaping 2024

The traditional and conservative realm of healthcare has experienced significant and swift technological upheaval in the last ten years. The surge of generative AI and Large Language Models (LLMs) has outpaced any previous innovation wave, revolutionizing the landscape. While lauded as potential remedies for numerous healthcare challenges, these innovations confront the digital health industry with […]
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