Tag: Revenue Cycle Management

Patient Financial Encounters

Customize Patient Financial Encounters For Revenue Cycle Success

Healthcare is a top priority for American voters and there aren’t dramatic differences by ideology, according to a new survey. Adopted from the marketing industry, customer segmentation allows health systems to further customize the patient financial experience and help them get paid. Key Takeaways Tailor billing strategies and patient payment options to a financial situation […]
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Denial Management Services

How to Prevent and Manage Claim Denials

For many healthcare providers, claim denials are a frustrating cost of doing business. Each year, around 5-10% of medical billing claims are rejected (possibly more). With each claim costing around $25 to rework, providers lose billions in eroded revenue and productivity. Any revenue leakage is bad enough, but the shift towards value-based care means tighter revenue cycle management […]
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Clinical Denials

Clinical Denials: Prevention Is The Best Medicine

Clinical denials are a fact of life for hospitals. Providers must contend with a number of government audits conducted by several different organizations. On the private payer side, hospitals must comply with complex approval processes related to prior authorizations, admission status and medical necessity. At Becker’s Hospital Review’s 10th Annual Meeting in Chicago, R1 RCM hosted a […]
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Automate RCM with Robotic Process Automation

Take Your Revenue Cycle To The Next Level With Robotic Process Automation

To remain fiscally viable, hospitals and health systems must ensure reimbursement is collected properly and in a timely fashion. Healthcare’s “perfect storm” — the ever-increasing cost of care paired with the complexity of technology and rising expenses — has intensified this pressure, according to David Millen, vice president of information technology and digital transformation at […]
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AI

How Artificial Intelligence, Analytics & Automation are Reshaping Hospital Revenue Cycle

The accelerating challenge around patient needs’ calls for new technology and automation, but on a personal level. As hospitals turn to technology to overhaul the patient experience and improve profits, a range of vendors are bringing new products and outsourced services to meet that demand with artificial intelligence, data analytics and natural language processing as […]
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Pain Management

Pain Management and The Global Period

Pain management during the global period of a procedure, if related to that procedure, is not separately reportable. If a provider other than the operating provider performs follow-up care, you must be careful to avoid “unbundling” of that follow-up care. The global period, or global surgical package, bundles all care typically related to surgical service into a […]
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Medicare Quality & Cost

Better Quality, Lower Health Care Costs – Providers & Payers Share Risk

Denied claims are one of physicians’ chief complaints when it comes to dealing with payers. To a certain extent, every practice deals with claim denials. It’s those practices that eliminate the most common reasons that experience a smoother revenue cycle and find greater financial success. News Brief A capitation payment model results in better value […]
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Top 13 Reasons For Claim Denials

Top 13 Reasons For Claim Denials

Denied claims are one of physicians’ chief complaints when it comes to dealing with payers. To a certain extent, every practice deals with claim denials. It’s those practices that eliminate the most common reasons that experience a smoother revenue cycle and find greater financial success. Here are the 13 most common reasons for why claims […]
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Medicare-IRF-Proposed-Rule

CMS Posts 2020 IRF Proposed Rule

The focus on electronic health record implementation has turned to how to make use of the vast data stored within to improve revenue cycle operations (IRF). Proposed rule calls amending regulations clarifying the determination as to whether a physician qualifies as a rehabilitation physician is made by the IRF. The Centers for Medicare & Medicaid […]
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