Financial Experts in Healthcare

Pharmacy May Be The Answer To Reducing Healthcare Costs

2017-04-02T13:28:16-04:00By |Financial, Financial Analysis, Readmissions, Revenue Cycle Improvement|

Back in March, we talked about how the role of the pharmacist in the healthcare ecosystem has been expanding over the past decade. In addition to simple medication fulfillment, pharmacist now complete crucial patient aftercare, education, and vaccination administration. Many believe as the role of the pharmacist expands, they could become the key to reducing all kinds of healthcare costs. Here are three ways pharmacy is helping save costs for healthcare.

15 Reasons For Claim Denials and How To Prevent Them

2017-04-02T13:28:18-04:00By |Financial, Lean Management, Services|

Claims get denied for a variety of reasons - some of them are extremely simple to remedied, while others may require entire shifts in your organizational structure. The question is, could any of them been prevented? Many claim denials are completely avoidable - and in fact there are practical ways you can combat claim denials. Look at the following common claim denial reasons and see if any of them have happened to you recently.

Denial Management Strategies

2024-06-26T11:10:37-04:00By |Financial, Lean Management|

The AMA reports that up to 5% of claims are denied, and that number is only expected to rise (perhaps by as much as 200%) with the initial implementation of ICD-10 later this year. Medical billing and coding, which is undergoing enormous changes with the implementation of ICD-10, is always an area where additional training for staff can be a positive investment in denial management. Providing continuing education for coders can help them be better prepared to identify potentially problematic documentation, and be able to code with the highest level of accuracy. It’s often been said that the best defense against denials is — frankly — avoiding denials, but if that’s proving uneasy, if it seems to be near-impossible, the next best defense is to do a root cause analysis so that you understand why the denials continue.

Strategies for Payer Negotiation

2017-04-02T13:28:19-04:00By |Financial, Financial Analysis, Services|

When it comes to procuring and maintaining your contracts with payers, there is perhaps no skillset greater to possess than that of the art of negotiation. In today’s healthcare market, there’s not only a need to be informed and competitive, but healthcare organizations need to have a very clear understanding of where they stand amid the competition.

2015 Healthcare Reimbursement Challenges

2017-04-02T13:28:20-04:00By |Clinical Operations Improvement, Financial|

One of the most talked about aspect of healthcare reform is the changing payment taxonomy which will dictate how payers and patients pay providers for services. The ongoing struggle to contain healthcare costs, which have been spiraling out of control for decades under the unsustainable fee-for-service model of payment, is likely a long while away from being corrected in toto. At this stage in the game, even a little progress in a direction towards savings is reason for hope.

5 Ways The Expanding Role of the Pharmacist Is Changing Healthcare

2023-08-12T16:43:24-04:00By |Accreditation, Financial, Readmissions, Revenue Cycle Improvement, Strategic Planning|

The role of the pharmacist in the healthcare industry has been expanding over the past decade, from simple medication fulfillment to crucial patient aftercare, education, and administering vaccinations. 2015 has already seen big changes within the healthcare industry and we predict that the role of the pharmacist will only expand more.

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