Tag: Revenue Cycle Management

Impacts of Claim Denials on Revenue Cycle

How Claim Denials and Payer Audits Impacts Healthcare Revenue Cycle

Denial rates, notably within Medicare Advantage, are on the rise, impacting both hospital revenue cycles and patient care, remarked the executive director of a Minnesota-based large multispecialty health care organization focused on Revenue Cycle management. Despite the organization reporting a favorable margin this year, it falls short in achieving profits comparable to those of insurers, […]
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The Rise of Hybrid Global Outsourcing Models in Healthcare

Given labor shortages and financial constraints, fully managed hybrid outsourcing solutions are increasingly gaining prominence. Hospitals and provider organizations grapple with staffing deficiencies across various departments, with the revenue cycle facing considerable strain. A recent survey among medical group leaders highlighted coders as the most challenging role to fill, closely followed by billers, schedulers, authorization […]
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Understanding ABNs for Providers and Medicare Beneficiaries

The Advance Beneficiary Notice (ABN), Form CMS-R-131, issued by the Centers for Medicare & Medicaid Services (CMS), holds immense importance for healthcare providers, revenue cycle teams, and Medicare beneficiaries. What is an ABN (Advance Beneficiary Notice)? An ABN, formally extended to Medicare Fee-for-Service (FFS) beneficiaries, precedes outpatient services like labs, imaging, physical therapy, or observation. […]
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Unveiling the Top 5 Healthcare Revenue Cycle KPIs

Key Performance Indicators (KPIs) within the healthcare revenue cycle play a vital role in monitoring financial well-being and optimizing revenue capture for providers. Understanding these metrics is crucial for healthcare organizations aiming to sustain access to high-quality, cost-effective care—an essential aspect of the evolving landscape of value-based care and healthcare consumerism. These KPIs offer critical […]
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2024-Medicare-Telehealth-reimbursement-waiver

Medicare’s Telehealth Reimbursement Waiver Extended to 2024

The final 2024 Medicare Physician Fee Schedule includes a provision that allows health systems to bill Medicare for telehealth services provided by doctors from their homes. This extension of a crucial Medicare reimbursement for health systems using telehealth services lasts until the end of 2024, and it also grants physicians working from home added privacy […]
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How does autonomous coding improve revenue cycle?

A survey revealed that healthcare organizations anticipate that autonomous coding will accelerate the revenue cycle process and enhance coding accuracy. Although autonomous coding has the potential to streamline revenue cycle processes and alleviate administrative burdens, a majority of healthcare finance leaders surveyed either lack familiarity with it or harbor reservations about fully trusting this automated […]
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Key Survey Findings: Common Causes of Healthcare Claim Denials

According to a recent survey, eligibility and prior authorization issues were among the most prevalent causes of claim denials. Hospitals and healthcare systems are experiencing an uptick in claim rejections due to errors in front-end revenue cycle processes. The Healthcare Financial Management Association’s Pulse Survey program, conducted for a healthcare technology company, gathered responses from […]
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The Profound Importance Of Medical Coding Services in Healthcare Reimbursement

In the intricate realm of healthcare, where patient well-being is paramount, the financial dimension often receives less attention. Yet, it’s imperative to recognize that healthcare encompasses not only patient treatment but also ensuring fair compensation for healthcare providers. Precise medical coding is a cornerstone of this endeavor. This piece delves into the profound importance of […]
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