Category: Revenue Cycle Management

AI in RCM

Artificial Intelligence: The Benefits to Revenue Cycle Management

Artificial intelligence (AI) is a concept that has moved very quickly from the realm of science fiction into real and practical utility in a number of different industries—including healthcare. One of the most effective applications for AI-powered tools is in the field of revenue cycle management. Sophisticated AI technologies can sift through vast amounts of […]
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Reimbursement Loss

Strategies to Mitigate Shrinking Reimbursement in Emergency Medicine

Emergency departments are under intense pressure to do more with less, and drilling down into clinical and operational data can provide opportunities to offset decreasing revenues Many emergency providers are starting to find themselves caught within a perfect storm, with pressure from reduced reimbursements building steadily across all payer types. Medicare payments for emergency care have effectively […]
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How Healthcare Organizations Can Capture All Revenue

  Hospital billing departments coordinate health plan benefits every day. Typically, coordination of benefits (COB) is aided by patient registration workflows that gather basic demographic and health insurance information. But what if a patient gets hurt on the job or in an automobile accident? How well does your organization collect the information needed to coordinate […]
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RPA and AI in Revenue Cycle Management

The ROI of RPA and AI in The Revenue Cycle

HBI data reveals that the rate of hospitals or health systems that have implemented artificial intelligence for any revenue cycle function has not widely increased over the past year, but automation in healthcare has shown some forward movement in comparison. Based on the conversations revenue cycle analysts have conducted with HBI members over the past […]
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E/M Coding

AMA Releases Online Checklist for E/M Coding Services Transition

The American Medical Association issued a checklist for the transition to fundamental changes in evaluation and management (E/M) services, a medical coding process in support of medical billing which practicing healthcare providers must use to be reimbursed by Medicare, Medicaid programs or private insurance. The checklist provides a guide for physician practices, which already are […]
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Physicians Stark Law

More New Rules from CMS for FY 2020

Among the proposed new rules is one intended to clarify the contentious “Stark Law” On Oct. 9, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to modernize and clarify the regulations that interpret the Medicare physician self-referral law (often called the “Stark Law”). The law prohibits physicians from making referrals for […]
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