Blog Archives

4 Targets For Resource Improvement

revenue cycle

Many hospitals are currently asking themselves, “How can we improve our revenue cycle in 2015?”
This topic is also one many C-suite executives are facing in 2015, which is proving to be another year of vast changes. Financial departments will have to stay on top of contract management, as well as planning for shifts in how payments are received.
Today, we’ve put together a list of 5 ways healthcare providers can reboot their revenue cycles and stay ahead of those changes that impact the bottom line.

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Posted in Revenue Cycle Improvement, Services

Data Management Is Denial Management

Denial Management:

You know your reimbursement process needs attention when the response to an adverse determination is to resend the exact same paperwork through the pipeline. In a few cases, the ROI on a resend appears reasonable, but peel back the band-aid and you will find a process needing attention. Understanding data management is denial management begins the healing process.

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Posted in Quality Improvement Programs, Revenue Cycle Improvement

Payers and Providers Value-Based Care Reimbursement

value based care

Value-based care reimbursement models (VBR) are becoming a popular choice for many healthcare providers and payers, as fee-for-service, (and traditional incentive based payment models), are phased out. According to a recent McKesson survey “Journey to Value: The State of Value-Based Reimbursement in 2016,” 58% of payers and hospitals are planning to adopt value-based care reimbursement models.

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Posted in Population Health, Revenue Cycle Improvement

6 Tips for Reducing Claims Denials

Optimizing your revenue cycle starts with reducing denials. In order to do this, you must have an effective Denial Management strategy in place. According to a new HIMSS Analytics study, 56% of hospitals surveyed said they don’t use a vendor solution for claim denials. However, around 60% of those respondents are planning on purchasing a claims denials management tool within the next year. If you are part of the 40%, now may be the time to think about investing in tools for claims denials.

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Posted in Revenue Cycle Improvement

Turn Your Denials Around: Denial Management Focus

4 helpful tips to reduce claim denials

Health insurance claim denials could be causing your organization to lose a significant amount of revenue each year. An effective Denial Management strategy is one of the fastest ways to recoup lost revenue, and ensure that you are being paid for the care that you are providing.

Studies indicate that approximately 25-30% of healthcare claims are rejected or denied. This results in millions of dollars of lost revenue each year. The majority of these losses can be avoided by implementing our unique denial management process.

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Posted in Revenue Cycle Improvement

Spin Cycle: Tips for Understanding Revenue

revenue cycles

When it comes to revenue cycles, the amount of processes and subtleties involved are endless. Whether small or large all these steps impact the organization’s financial standing. It’s also easy to identify areas which…

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Posted in Revenue Cycle Improvement

More Competition? Specialty Pharmacy Growth

The benefits of Specialty Pharmacies for hospitals and health systems

The specialty pharmacy industry is booming and as many pharmacies opt for moving down the specialty pharmacy accreditation path, many hospitals and healthcare systems are starting to realize opening their own specialty pharmacies (or partnership with one) could be a good idea. The jump to specialty pharmacy for a health system or hospital, isn’t only a revenue driver as it gives them access but could also help with re-admissions, quality of care, and data collection. And as specialty pharmacies crop up all over the country, with an estimated 250 to be accredited by the end of 2015, it is the perfect opportunity for health systems to take fate into their own hands. From driving revenue, to increasing quality of care here are three main areas a hospital or health system can benefit in an in-house specialty pharmacy.

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Posted in Accreditation, Care Coordination, Clinical Operations Improvement, Financial, Healthcare Prevention, Pharmacy Accreditation, Readmissions, Revenue Cycle Improvement, Specialty Pharmacy Accreditation

Denial Management: Improvement Through Data Analysis

Denial Management:

Health insurance claim denials cause many healthcare organizations to lose a significant amount of money each year. In fact, large health organizations frequently lose millions of dollars per year due to ineffective denial strategies.

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Posted in Quality Improvement Programs, Revenue Cycle Improvement

5 Ways Revenue Cycle Management (RCM) Reduces Errors & Increases Revenue

5 Ways Revenue Cycle Management Reduced Error & Generates Revenue

With new advances in the way medical information is transcribed, stored and transferred, technology has created more variables to a provider’s success than ever before. Between tangling with mountains worth of paperwork, handling claims denials and riding the learning curve of new systems like EHRs and ICD-10 coding, there can be lots of room for error and, consequently, potential revenue that slips through the cracks.

Luckily, revenue cycle management systems are here to help. They can streamline a vast array of your most intensive processes — like admitting, coding, balancing budgets, billing and filing claims — in order to provide a supreme level of oversight and control. This control in turn helps you avoid common RCM problems that lead to lost revenue, profitability and productivity.

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Posted in Clinical Operations Improvement, Financial, Financial Analysis, Revenue Cycle Improvement, Services

Common Revenue Cycle Management Pitfalls to Avoid

common revenue cycle management pitfalls to avoid

When asked what the key to success is, most business owners will tell you the ability to stay competitive in the marketplace. Staying competitive is particularly important in the health care field where the financial success of a physician practice is fundamentally based on provider productivity and revenue cycle management. A practice that’s unable to reduce revenue leaks and increase their bottom line will have a hard time staying afloat.

When it comes to minimizing costs and managing revenue, medical practices of all sizes make the same mistakes. Here are 7 common RCM pitfalls to avoid at all costs.

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Posted in Financial, Guest Post, Revenue Cycle Improvement

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