The average health system saw 110,000 claim denials due to prior authorization and other factors in 2022, a recent study says. KEY TAKEAWAYS: Revenue cycle leaders are placing denials management at the top of the list of areas to improve for...
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Outsourcing the medical billing process reshapes healthcare sectors by building better and more stable revenue cycle management systems and helps businesses in the long run. Also, outsourcing pulls down the operating costs and strengthens the...
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A recent survey highlighted how payment cuts are affecting denial strategies. Healthcare organizations are on the verge of stepping up their denials management strategies in 2023 as rate cuts are expected to impact revenue. On the delivery side...
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In 30 years of running revenue management the usual suspects come up in a Key Performance Indicator (KPI) Dashboard such as Charges, Payments, Adjustments, Net Collection, Gross Collection, Days in AR, AR over 90 Days and Bad Debt. Then you have...
More InfoA new analysis shows that claim denial rates for in-network services among Healthcare.gov marketplace payers varied significantly, with some as high as 80%. Claim denial rates varied significantly among Healthcare.gov marketplace payers, with...
More InfoMore than 80% of leading health systems that are using RPA/AI say their primary reason for investing in the technology was improving financial performance, but once the technology was in use, they said efficiency was the top benefit. The reasons...
More InfoHHS reduced the Medicare appeals backlog by 79 percent during the third quarter of FY 2021, putting the department ahead of schedule to clear the backlog. As of June 30, 2021, the end of the third quarter of FY 2021, HHS had 86,063 pending...
More InfoAverage claim denial rates are between 6% and 13%, but some hospitals are nearing a “danger zone” after COVID-19, a survey shows. Hospital claim denial rates are at an all-time high, signaling a need for better claims denial management, a recent...
More InfoDays in accounts receivable (A/R) is one of the most important key performance indicators for growing practices. In an increasingly complex healthcare environment—and one in which financial responsibility is shifting to the patient—keeping track...
More InfoTypical CDI programs are intended to drive reimbursement through diagnosis securement, contributing to improved case mix index. The COVID-19 pandemic is placing monumental financial stressors upon hospitals, with added costs to treat patients...
More InfoIf there’s one thing healthcare providers can agree on, it’s that prior authorization management is a heavy administrative burden and only growing heavier. Decades ago, it was created to ensure care standards continuity, improve safety and...
More InfoThere’s nothing more frustrating than rendering a service and not being paid. Sometimes the problem comes down to a single code. Nuanced coding rules are difficult to understand, and physicians aren’t taught this information in medical school...
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