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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When a claim gets denied, it not only affects the company’s cash flow but also impacts the patient-doctor relationship. Even some denials get claimed by re-appealing but few claims are left on air – that what something your practice and...
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The patient financial experience and No Surprises Act are top of mind for revenue cycle leaders as we move into 2023. As hospitals try to navigate the COVID-19 crisis, inflation, labor shortages, and rising expenses, organizations are going to...
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The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA). In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior...
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Partnering with a vendor that provides EHR and RCM capabilities helped one healthcare organization boost communication and improve revenue cycle efficiency for 150 care centers. Leveraging automation for revenue cycle management (RCM) processes...
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Some commercial health insurers are using policies that can delay patient care and create burden for providers, causing relationships with hospitals to worsen, according to a survey by AHA. The association fielded responses from more than 200...
More InfoSurvey shows little progress after four years of promises The American Medical Association says that despite insurance industry promises to reform and improve prior authorizations, little effort has been made to do so. This comes despite evidence...
More InfoA focus on front-end revenue cycle efficiency can help to avoid costly medical necessity denials. KEY TAKEAWAYS Four words often describe the efforts to prevent denials related to medical necessity: too little, too late. Mistakes are made early...
More Info‘If you can get it right up front, you’re ensuring accuracy, preventing rework, and preventing denials,’ says Alicia Auman, director of patient access at KSB Hospital. Patient access plays a tremendously important role within...
More InfoDevice agnostic digital patient intake; buy now, pay later; compassionate billing; and AI-enabled customizable payment plans are four trends that rev cycle leaders should watch as the pandemic rages on. Despite promises of a “hot-vaxxed...
More InfoFirst hand experiences from the country’s most innovative revenue cycles will be shared next month in West Palm Beach, Florida. What issues keep revenue cycle executives up at night? As the HealthLeaders’ revenue cycle editor, I will...
More InfoHospital and health system executives should monitor these proposals for provisions that will affect their organizations’ operations. The 2020 annual rule cycle has been active for CMS. Several proposals in the outpatient prospective...
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