The Rising Denial Rates in Healthcare Claims Processing Initial Claim Denials: In a new survey conducted by healthcare Company an increased percentage of initial claims are denied by private payers, including pre-approvals for medical claims. Hospitals, health systems, and post-acute care providers may have a difficult time getting paid for medical services. The survey respondents […]
Discover how healthcare providers can accelerate cash flow, minimize denials, reduce operational costs, and enhance patient satisfaction through streamlined Revenue Cycle Management (RCM). RCM is a strategic approach to overseeing all financial aspects of a patient’s journey, from initial appointment scheduling to final bill payment. This article highlights the critical role RCM plays in maximizing […]
Higher satisfaction with problem resolution was observed among beneficiaries who were more inclined to renew their Medicare Advantage plan. Medicare Advantage plans have garnered favorable satisfaction scores, with beneficiaries showing high approval ratings for trustworthiness, operational ease, and coverage adequacy, as outlined in a recent market research study. The 2023 US Medicare Advantage Study encompasses […]
The medical billing industry is constantly evolving, with new technologies and trends emerging all the time. As the healthcare industry continues to change, so too will the way medical billing is done. Here are some of the trends that are expected to shape the future of medical billing: The increasing use of electronic health records […]
Despite ongoing concerns about denials and beneficiary access to care, Medicare Advantage (MA) companies remain in the spotlight as their market penetration continues to grow. In April 2022, a report from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) highlighted a significant issue in the capitated payment model employed […]
The healthcare industry is on the brink of transformation, as a multitude of emerging technologies and trends, such as artificial intelligence, virtual reality, telehealth, and blockchain, are set to revolutionize it. The pace of innovation in healthcare technology is relentless and shows no signs of decelerating. A myriad of emerging technologies and trends, such as […]
Here are four must-know key performance indicators that providers should know and use when looking to improve outcomes and the patient experience. Key performance indicators (KPIs) have always mattered, but they are now more relevant than ever in the healthcare industry, as providers make the shift to value-based care. While there are many common types […]
The rapid rise of telemedicine in response to the COVID-19 outbreak has been critical for getting at-risk patients the care they need. In fact, many state governments are working to expand telehealth within their Medicaid programs, while also easing restrictions to allow for faster implementation. And there is evidence that this trend will not be reversed anytime soon. […]
The healthcare revenue cycle has become even more complex in recent years for several reasons, including increased patient financial responsibility, more complicated payer contracts and greater regulatory demands. As a result, providers across the nation have been forced to change their approaches to revenue cycle modernization. Despite attempts to modernize the revenue cycle to meet […]
Artificial intelligence (AI) has received a lot of buzz and been positioned as the central healthcare technology needed to solve many financial challenges and digitally transform internal operations. However, if you’re looking for practical solutions that can address variable activities and complete work with a high level of quality, today, healthcare organizations should look to intelligent […]