Category: Revenue Cycle Management

RCM automation

Maximizing A/R Efficiency with RCM Automation

A well-managed A/R process ensures timely cash flow, reduces administrative burdens, and maintains the stability of a healthcare practice. However, many healthcare practices still struggle with outdated, manual A/R management processes that can lead to inefficiencies, errors, and delayed payments. In recent years, Revenue Cycle Management (RCM) automation has emerged as a game-changer in addressing […]
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Denial Management Process

3 Proactive Strategies for Improving Denial Management

In the ever-evolving field of medical billing, denied claims remain a significant obstacle for healthcare providers. Studies reveal that over 10% of claims face initial rejection by insurers, leading to revenue losses, administrative strain, and frustration for all stakeholders. To mitigate these challenges and ensure financial stability, an effective denial management process is essential. However, […]
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AI in Revenue Cycle Management

How AI is Revolutionizing Revenue Cycle Management

However, AI in Revenue Cycle Management is emerging as a transformative solution. By automating repetitive tasks, improving accuracy, and providing actionable insights, AI is helping healthcare organizations streamline their processes and tackle these challenges more effectively. Revenue Cycle Management (RCM) is a cornerstone of healthcare operations, yet the growing complexity of today’s healthcare landscape poses […]
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claim denials with chiropractic

Preventing Denied E&M Claims with Chiropractic Manipulative Therapy (CMT)

The observed an increasing number of denied Evaluation and Management (E&M) claims (99201-99215) when billed concurrently with chiropractic manipulation procedures, including chiropractic manipulative therapy (CMT), highlighting the potential for increased claim denials with Chiropractic Manipulative Therapy (CMT). Denial Reasons & Misconceptions: Common denial reasons include: “Service billed is included in another procedure billed the same […]
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Healthcare RCM with AI

Transforming Revenue Cycle Management: AI’s Role in Healthcare Success

As healthcare providers move into 2025, a technological revolution is reshaping revenue cycle management (RCM). Healthcare RCM with AI has emerged as a decisive factor in determining financial success or failure. With nearly 46% of hospitals and health systems already leveraging AI in their RCM operations, the industry faces a pivotal moment where keeping pace […]
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End to End RCM

End-to-End Revenue Cycle Management: A Comprehensive Guide

End to end RCM (Revenue Cycle Management) encompasses every step in the healthcare payment process, from patient registration to final reimbursement. By adopting a comprehensive RCM approach, healthcare organizations can improve cash flow, minimize errors, and ensure compliance with ever-changing regulations. This blog will explore the components, benefits, and best practices for implementing an end […]
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HIPAA-compliant e-signatures

The Ultimate Guide to HIPAA-Compliant E-Signatures in Healthcare

This blog delves into the critical aspects of HIPAA-compliant e-signatures in healthcare, exploring how to leverage their efficiency while ensuring strict adherence to HIPAA regulations. HIPAA’s Stance on E-Signatures Early Considerations: HIPAA initially envisioned standards for electronic signatures, focusing on financial transactions. However, early digital signature technology proved inadequate for the stringent security requirements. Shift […]
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Automated Insurance Eligibility Checks

Automated Insurance Eligibility Checks: Improving AR Days

Table of Contents Understanding the Impact of Denials and AR Days The Role of Automated Insurance Eligibility Checks Benefits of Automated Insurance Eligibility Checks Implementing Automated Insurance Eligibility Checks Insurance Eligibility Verification Service: A Critical Step for Healthcare Practices One significant challenge that healthcare providers face is the high rate of insurance claim denials and […]
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Medicare Advantage organization determinations

CMS Clarifies Organization Determinations: Key Updates for Medicare Advantage

The Centers for Medicare & Medicaid Services (CMS) has introduced significant updates to clarify the definition and processes related to Medicare Advantage organization determinations, particularly in inpatient settings. The proposed rule reaffirms that decisions made during concurrent reviews, such as reclassifying an inpatient admission to outpatient or denying inpatient coverage, qualify as organization determinations under […]
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Improve revenue cycle management

Effective 5 Ways to Improve Revenue Cycle Management

The healthcare industry operates under a unique framework. Unlike traditional businesses where customers pay directly for a product or service, healthcare providers navigate a complex system involving multiple players, including payers, claims management, and reimbursements. To Improve Revenue Cycle Management, healthcare providers must understand this intricate system and implement efficient strategies to optimize their revenue […]
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