Category: Revenue Cycle Management

The State of Claims and Denials in 2023

The State of Claims and Denials in 2023

How do you resolve a repeated and shooting up problem like claims denials? It’s been a fresher subject for revenue cycle management professionals for years that are only experiencing hotter with the growing pressures of staffing shortages, troubles with staff movement and instructing and developing policies and protocols at the government and payer levels. On […]
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Three Ways to Outsmart Denials in 2023

Three Ways to Outsmart Denials in 2023

Denial rates serve as a barometer for the financial well-being of healthcare organizations. An increase in denials can have wide-ranging negative implications for an organization — impacting everything from accounts receivable to the patient experience. By preventing denials upfront, providers can realize revenue faster, boost staff efficiency and satisfaction, and reduce patient anxiety related to […]
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Top Trends Of Revenue Cycle In 2023

Top Trends Of Revenue Cycle In 2023

Healthcare providers before reeling down the effect of the extended period of misfortune due to COVID-19 were additionally affected by pretentious impact and rising cost of healthcare supplies. RCM leaders are currently focused on two central themes: safeguarding their revenue and maximizing efficiency with limited resources. Unfortunately, the effects of the great resignation have resulted […]
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Five Healthcare Trends To Note In 2023

Five Healthcare Trends To Note In 2023

The leaders’ guide on what’s shaping the industry. Now is the time for decisive action and visionary leadership as the healthcare industry moves past the urgency of the pandemic—which forever changed care delivery and the workforce—to opportunities that will create a more patient-centric and sustainable healthcare system. That takes a watchful eye from leaders on […]
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Six Steps to Prevent Readmission Denials

Six Steps to Prevent Readmission Denials

Prevention of readmission denials improves case mix index (CMI), reimbursement, and quality metrics. As a consultant, I am like the FBI – if you invite me in, I will likely take your case. This often leads to varied and challenging projects. Often, I am engaged to assess opportunity in provider documentation, clinical documentation integrity (CDI) […]
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CMS Aims To Streamline Prior Authorization To Reform MA

CMS Aims To Streamline Prior Authorization To Reform MA

The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA). In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing. The Biden administration has shown a commitment to increasing oversight of […]
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