Archive


Category: claims management

  • Deep diving into a successful healthcare revenue cycle flowchart

    An efficient revenue cycle management (RCM) system is a win-win for patients and providers. Friction-free solutions that cover everything from booking appointments to paying bills create a more satisfying patient experience and allow patients to focus on their health. Providers can lower administrative costs and generate more revenue from data-driven billing and collections operations. To […]

  • Better claims management: faster patient payments & reduced denials

    Navigating an increasingly complex reimbursement landscape remains challenging for today’s healthcare providers, with too many claims still underpaid, delayed or outright denied. In fact, nearly 70% of providers said the problem of denied claims had worsened during 2021. Naturally, relationships with payers suffer, adding friction to the process. To this end, revenue cycle leaders are […]

  • 7 top healthcare revenue cycle challenges and how to overcome them

    Healthcare revenue cycle challenges exist at every stage of the patient journey, beginning with patient access and extending all the way through claims, billing, payment and collections. However, digital tools and analytics can help providers tackle their top healthcare revenue cycle challenges. “The complexity of our reimbursement structures and the complexity of billing mean a […]

  • How to prepare for CMS’s Appropriate Use Criteria Program

    The Appropriate Use Criteria (AUC) program is due to come into full effect in January 2023 at the earliest. The program was established by the Centers for Medicare and Medicaid Services (CMS) to help providers order the most appropriate diagnostic imaging services. Failure to comply may result in claims denials. Any provider that offers these […]

  • Why patient experience matters to your revenue cycle

    Patient experience may not be the first consideration that comes to mind when you’re looking to improve revenue cycle management (RCM). However, a positive patient experience can benefit RCM. It can make the complicated process of understanding and managing healthcare finances simpler and more seamless for patients—and facilitate an easy-to-navigate continuum of care that includes […]

  • 6 strategies on how to increase outpatient revenue

    Clinical advances, consumer demand and payer pressure are driving growth in outpatient care, which continues to attract attention as a lower-risk, lower-cost revenue stream for healthcare providers. New technologies allow for less invasive procedures and quicker recovery times, so patients can avoid lengthy hospital stays – and the higher out-of-pocket costs that come with them. […]

  • Revenue cycle management checklist: improve experience & profits

    Traditional revenue cycle management strategies are on shaky ground. Time-consuming manual processes are struggling under the burden of increasing patient volumes and patient financial responsibility. Clunky interfaces and disjointed systems fall short of evolving consumer expectations. Understanding and adapting to sweeping regulatory change is challenging for understaffed teams. On top of all of that, the […]

  • 3 data-driven denial management strategies for faster claims processing

    In the sixth article in our series on how the patient journey has evolved since the onset of COVID-19, we look at three ways to prevent claim denials and reduce the time to payment. Faster claims processing is at the heart of a better patient financial experience and reduces revenue leakage for providers. For more […]

  • What is Revenue Cycle Management?

    There is no question that providers’ bottom line has been hit hard this year, and a new surge in COVID-19 is bound to threaten hospital finances once again. As healthcare providers look to supercharge their payment velocity during these uncertain times, it’s worth taking a step back to examine the revenue cycle management process as […]

  • Five ways to reduce claim denials

    Claims denials put a big dent into the budgets of healthcare providers – something many organizations can’t afford today given the current pandemic. In an environment where everyone must do more with less, reducing claim denials could release vital revenue and staff time to create breathing space for quality improvement. The good news? About 90% […]

  • How to avoid patient misidentification and claims denials amidst COVID-19

    For many of the 36 million Americans who have registered for unemployment benefits during the coronavirus outbreak, losing their job means losing their health insurance. Options for the newly-unemployed are limited yet complicated: while the federal government has declined to reopen enrollment under the Affordable Care Act, several states are supporting those without coverage by […]