Tag: Revenue Cycle Management

Improve revenue cycle management

Effective 5 Ways to Improve Revenue Cycle Management

The healthcare industry operates under a unique framework. Unlike traditional businesses where customers pay directly for a product or service, healthcare providers navigate a complex system involving multiple players, including payers, claims management, and reimbursements. To Improve Revenue Cycle Management, healthcare providers must understand this intricate system and implement efficient strategies to optimize their revenue […]
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ICD-10 medical billing outsourcing

ICD-10 Medical Billing Outsourcing: A Strategic Solution for Healthcare Providers

The healthcare industry is in a perpetual state of change. A significant milestone occurred when the United States mandated the use of ICD-10 billing codes. This shift transformed billing procedures for medical providers, from solo physician practices to large hospitals. As a result, ICD10 medical billing outsourcing has become a critical solution for managing the […]
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healthcare billing

How AI Revolutionizes Healthcare Billing: Tackling Payment Delays and Denials

During pediatric cardiology internship, witnessed this firsthand. A claim filed nearly a year earlier remained unpaid. The initial denial was due to a missing prior authorization number, a detail buried within the EMR. Unfortunately, the outsourced healthcare billing team took months to decipher this information, causing significant delays in reimbursement. This year-long ordeal highlights the […]
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Charge Capture in Healthcare

Charge Capture: A Critical Step in Revenue Cycle Management

Charge Capture in Healthcare, a critical component of the revenue cycle management process, involves the accurate and timely documentation of all services rendered to patients. This includes procedures, tests, medications, and other healthcare services. While it may seem like a simple task, effective healthcare charge capture is essential to ensure optimal revenue cycle performance and […]
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Healthcare Claims Management

Healthcare Claims Management: Overcoming Denials and Optimizing Revenue Cycle

Claim denials continue to pose a significant challenge to healthcare claims management. Recent surveys indicate a substantial increase in denial rates, with many providers experiencing denial rates exceeding 10%. This issue has far-reaching consequences, impacting operational efficiency, financial stability, and ultimately, patient care The High Cost of Denials Healthcare providers face substantial financial losses due […]
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Optimizing RCM

Optimize Revenue Cycle Management: Strategies for Value-Based Care

The healthcare industry continues to face significant challenges, driven by value-based care initiatives, evolving payer models, and increasingly stringent regulations. To optimize revenue cycle management and ensure financial sustainability, healthcare providers must adapt to these changes . The COVID-19 pandemic exacerbated these challenges, leading to historically low margins and high costs, particularly in labor. Simultaneously, […]
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Medicare Physician Reimbursement Cuts

Medicare Physician Reimbursement Cuts Threaten Patient Access to Care

With over 67 million Americans—nearly 20% of the population—relying on Medicare, the program plays a crucial role in ensuring access to quality healthcare. Unfortunately, looming Medicare physician reimbursement cuts threaten to undermine this vital service, potentially leading to reduced access to care and compromised patient outcomes Medicare physician reimbursement cuts, such as the proposed 2.8% […]
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Medical Billing Industry

Growth in the Medical Billing Industry: Trends and Challenges

The medical billing industry, while complex and often mired in regulatory hurdles, is experiencing a period of growth and transformation. A recent survey conducted by healthcare software company, a digital health operating system company, revealed that 65% of medical billing companies hold a positive outlook on the industry’s future. This optimism is fueled by several […]
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Benefits of Outsourcing rcm

The benefits of outsourcing RCM functions

Healthcare providers face a daunting task in managing the complexity of revenue cycle management (RCM) in today’s healthcare environment. One of the key benefits of outsourcing RCM is that it can significantly reduce these administrative burdens. The administrative burdens faced by healthcare organizations often rise as regulations, reimbursement models, and patient expectations change. As a […]
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Impact of Healthcare Reform on RCM

Healthcare Reform Update: How New Regulations Affect RCM

Health care in the United States is constantly changing, with new regulations and policies being developed to improve patient outcomes, increase access to care, and reduce costs. Impact of Healthcare Reform on RCM, keeping up with these changes is essential for Revenue Cycle Management (RCM) professionals. New regulations can impact everything from billing and coding […]
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