Healthcare providers before reeling down the effect of the extended period of misfortune due to COVID-19 were additionally affected by pretentious impact and rising cost of healthcare supplies. RCM leaders are currently focused on two central themes: safeguarding their revenue and maximizing efficiency with limited resources. Unfortunately, the effects of the great resignation have resulted […]
The leaders’ guide on what’s shaping the industry. Now is the time for decisive action and visionary leadership as the healthcare industry moves past the urgency of the pandemic—which forever changed care delivery and the workforce—to opportunities that will create a more patient-centric and sustainable healthcare system. That takes a watchful eye from leaders on […]
Error-free medical billing and coding are critical characteristics of a revamped revenue cycle system. Appropriate billing and coding are not only needed in terms of compliance but are also pivotal in bringing down medical claim denials and rejections. When you take a more dynamic approach to your billing and coding operation, you not only get […]
KEY TAKEAWAYS Denials rose to 11% of all claims last year, up nearly 8% from 2021. Revenue cycle leaders should place their focus on clinical validation denials to help ease the overall denials burden. A key defensive strategy for preventing denials is provider education. Revenue cycle leaders need to understand that clinical validation denials are […]
Medical claims denials are on the rise and continue to be a costly problem for health systems. Unfortunately, the vast majority of providers focus their resources on reactive responses, working to appeal denials and recover payments after denials have already occurred. In a Becker’s Healthcare podcast an expert, discussed the problem of rising denials, why […]
Each year the American Hospital Association (AHA) releases an advocacy agenda focusing on key areas in need of “critical support” for hospitals and health systems, and this year, quite a few key areas will be focused on your revenue cycle. “Hospitals and health systems are dealing with unprecedented challenges as they manage the aftershocks and […]
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 2023. Denials rose to 11% of all claims last year, up nearly 8% from […]
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 patient would like to avoid. Poor management in claim processing will negatively impact the revenue […]
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 finish out the year in the red, according to the latest National Hospital and Physician Flash […]
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 authorization, promote health equity, and curb deceptive marketing. The Biden administration has shown a commitment to increasing oversight of […]