Efficient revenue cycle management (RCM) is the linchpin that ensures a healthcare organization's financial health. In this article, we will explore the ins and outs of revenue cycle management, discuss its significance, and provide strategies to master this critical aspect of healthcare administration.
The healthcare industry has embraced a collaborative approach that is gaining significant traction—physician peer-to-peer reviews. In this comprehensive exploration, we will delve into the significance of physician peer-to-peer reviews, their role in enhancing healthcare, and how they strengthen the bonds within the medical community.
Physician advisor (PA) reviews play a crucial role in improving patient outcomes by facilitating various processes within healthcare organizations. PAs act as liaisons between hospital administration, clinical staff, and support personnel to ensure compliance with regulatory issues, advise physicians on medical necessity, and help achieve overall organizational goals related to the efficient utilization of healthcare services. Physician advisors contribute to better patient outcomes through several key activities.
To understand claim denials affecting reimbursement requires data. In healthcare, claim denials occur when an insurer or payer refuses to reimburse a healthcare provider for a particular medical service or treatment. Claim denials can occur for a variety of reasons, such as inaccurate or incomplete billing information, lack of medical necessity, or failure to follow the proper billing procedures.
Independent peer review plays a crucial role in revenue cycle management for the healthcare industry. Revenue cycle management (RCM) refers to the process of tracking patient care from registration to final payment, including all the administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.
Top At-Risk Conditions and utilization spikes that healthcare leaders and stakeholders across the industry must prepare to proactively address in the upcoming year highlight the recently released, 2023 State of Health – In The Aftermath Report. The report also presents predictive findings and explores the top contributing factors of many utilization increases.
In 2015, cancer deaths cost the U.S. $94 billion in lost earnings, according to a study published in JAMA Oncology.
The American Medical Association passed its first policy addressing augmented intelligence in the healthcare industry during its annual meeting in Chicago, which ran June 7 to June 13. The policy suggests tasks for the AMA to address regarding the use of AI in healthcare, with a focus on encouraging healthcare stakeholders and federal policymakers to prioritize "user-centered design." The initiative builds on a proposed a "baseline policy" the association laid out in a May report to its board of trustees.
The Trump Administration released “American Patients First,” the President’s blueprint to lower drug prices and reduce out-of-pocket costs. When it comes to the cost of prescription drugs, our healthcare system faces four major challenges: high list prices for drugs; seniors and government programs overpaying for drugs due to lack of the latest negotiation tools; out-of-pocket costs for consumers; and foreign governments free-riding off of American investment in innovation.
The Trump Administration released “American Patients First,” the President’s blueprint to lower drug prices and reduce out-of-pocket costs. When it comes to the cost of prescription drugs, our healthcare system faces four major challenges: high list prices for drugs; seniors and government programs overpaying for drugs due to lack of the latest negotiation tools; out-of-pocket costs for consumers; and foreign governments free-riding off of American investment in innovation.