Revenue Cycle Management

A healthcare organization's revenue cycle is its financial circulatory system. Preventing denials of claims and maintaining a visible, efficient billing process are key parts of a healthy revenue cycle. However, very few organizations have a perfect revenue cycle process. "Without some critical changes to provider workflow and revenue cycle management practices, providers will, in coming years, spend even more time and money chasing patient receivables and dealing with increased levels of uncollectible patient responsibility dollars," says Ralph Bernstein, senior vice president of U.S. Bank Healthcare Payment Solutions.

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Slideshow: C-suite, business office differ on perceptions of revenue cycle vendors
Visibility key to efficient revenue cycle management

 
A program that combines a mobile app, analytics and direct intervention is showing promise in reducing the costs associated with hospitals' most expensive patients -- the so-called "super-utilizers."
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Post date: September 19, 2014
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The value-based model of healthcare is gradually transitioning from the pilot phase to implementation, as health insurers and providers strive to offer better care while eliminating unnecessary costs. But for providers who have always been paid fee-for-service, it is a different way of thinking.
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Post date: September 17, 2014
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Predictive analytics uses a variety of statistical techniques that analyze current and historical facts in order to make predictions about the future. In the healthcare setting, such data analysis can be effective in addressing a variety of key issues, including preventable readmissions.
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Post date: September 16, 2014
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Weill Cornell Physicians, Cornell University's physician group, has inked a new accountable care agreement with Aetna, intended to enhance care for approximately 9,000 of the insurer's commercial and Medicare members in New York.
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Post date: September 11, 2014
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A Mississippi health system and three hospitals in Texas, Indiana and Alabama are illustrating how hospitals can thrive in a tough economic environment. The facilities recently won awards for their leadership in initiatives to improve financial sustainability and achieve significant financial performance improvements.
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Post date: August 29, 2014
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Healthcare organizations of all sizes continue to struggle with rapidly evolving models of population health-oriented reimbursement, according to a new report from Chilmark Research.
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Post date: August 29, 2014
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Nonprofit hospitals posted their second straight year of revenue declines in 2013 and their dismal rate of revenue growth broke records, according to a Moody's Investors Service report released this week.
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Post date: August 28, 2014
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In its June report to Congress, MedPAC made recommendations that would change the way post-acute care providers are reimbursed. Reviews from providers are mixed.
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Post date: August 27, 2014
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It wasn't all that long ago that most surgeries, and many medical and diagnostic procedures, required patients to plan for an inpatient hospital stay. But times have changed.
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Post date: August 25, 2014
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Although there are some indications of a possible lull, hospital systems are still buying up private physician practices at a high rate. With that come concerns about maintaining the revenue cycle during transition, but there are steps hospitals can take to smooth the process.
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Post date: August 6, 2014
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Money Atwal, who is both CFO and CIO at Hilo Medical Center in Hilo, Hawaii, shares with Healthcare Finance News how his organization is counteracting declining reimbursements and resources.
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Post date: July 29, 2014
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When it comes to speeding up the revenue cycle, the hospital pharmacy has its own part to play.
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Post date: July 28, 2014
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The Centers for Medicare & Medicaid Services has published a final rule updating the hospice wage index and payment rate for Fiscal Year 2015. It adopts a number of payment reforms addressing concerns about program integrity, beneficiary protection and quality.
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Post date: September 22, 2014
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In its new rules, CMS places great emphasis on the physician's documentation regarding his or her expectation of a patient's need for hospital care and anticipated length of stay. Therefore, it is essential that all hospital physicians are educated about the heightened importance of documentation within the medical record.
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Post date: September 15, 2014
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In its new rules, CMS places great emphasis on the physician's documentation regarding his or her expectation of a patient's need for hospital care and anticipated length of stay. Therefore, it is essential that all hospital physicians are educated about the heightened importance of documentation within the medical record.
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Post date: September 15, 2014
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According to the KISS principle, most systems work best if they're kept simple. Simplicity is the key goal in design, and unnecessary complexity should be avoided. Clinical documentation improvement and ICD-10 preparation are no exception.
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Post date: September 10, 2014
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Inpatient rehabilitation services are already a big target area for recovery audit contractors, and there will likely be more denials as audits ramp back up. Providers must remain consistent, proactive and vigilant to protect their revenue.
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Post date: September 8, 2014
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Working together, CFOs and CIOs can breathe new life into their growth strategy by thinking beyond architectural and functional limits of their EHRs. They must embrace new ideas and technologies that will introduce market advantages and the financial elixir of much-needed share gains.
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Post date: September 4, 2014
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Accountable care has taken a stronghold in today's healthcare environment, and the trend is progressing, according to respondents from Premier's semiannual Outlook survey.
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Post date: September 2, 2014
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Using automation technology to create an engaging payment experience for patients enables providers to see measurable operational and financial improvements including fewer days in accounts receivable, improved cash collections and reduced past-due accounts.
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Post date: August 14, 2014
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The changing payment model for patient care has made hiring more primary care physicians and adding specialty practice groups a strategic initiative for most health systems. But, unless a health system is set up to fully track the downstream revenue these physicians generate when measuring overall financial performance, the outcomes may not match what was anticipated within the strategy.
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Post date: August 11, 2014
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Imagine trying to run a successful business when employers, competitors, and other service providers have launched focused campaigns that encourage consumers to avoid you. If you run a restaurant or an auto-repair shop, this scenario is far-fetched. If you run a hospital, it's reality.
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Post date: August 8, 2014
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Just in case you didn't get the memo earlier this week, hospitals should take note that the Centers for Medicare & Medicaid Services will soon allow Recovery Auditors to restart some reviews.
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Post date: August 7, 2014
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Chief financial officers at hospitals and health systems must track a multitude of difficult financial issues these days. One question, however, always stops a conversation cold: Why are our reimbursements declining?
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Post date: August 7, 2014
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