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

 
The decision by lawmakers to delay implementation of ICD-10 by a year will give hospitals extra time to get ready for the transition, but will have a negative financial impact.
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Post date: April 2, 2014
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With Medicare's "two midnight rule" set to take effect later this year and audit appeals facing lengthy backlogs, the Recovery Audit Contractor program may be headed in some new directions.
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Post date: April 1, 2014
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The House of Representatives passed a bill yesterday to forestall scheduled cuts to Medicare physician payments through April 1, 2015, to delay the ICD-10 implementation deadline for one year, and to suspend enforcement of the controversial two-midnight policy.
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Post date: March 28, 2014
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The House of Representatives passed a bill yesterday to forestall scheduled cuts to Medicare physician payments through April 1, 2015, to delay the ICD-10 implementation deadline for one year, and to suspend enforcement of the controversial two-midnight policy.
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Post date: March 28, 2014
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When it comes to patient collections at small, community hospitals, the process can be much the same as at larger hospitals around the country, with one exception.
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Post date: March 25, 2014
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The quality of a hospital or health system is usually linked to patient outcomes, not to administrative or financial efficacy. But smooth interactions between patients and the hospital business office should also be viewed as critical to an organization's quality, says one CFO.
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Post date: March 19, 2014
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As Oregon transforms how it delivers care to 780,000 Medicaid patients, it hopes to generate better outcomes at lower costs. The problem for Oregon hospitals is that these goals conflict with the traditional aim of boosting revenue through ER visits and inpatient stays.
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Post date: March 12, 2014
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Now that health plans are required to be compliant with the newly adopted operating rules for electronic funds transfers and electronic remittance advice, electronic transactions might be poised to overtake healthcare.
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Post date: March 12, 2014
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As legacy revenue cycle systems struggle to keep up with constant regulatory changes, many hospitals are turning to next generation revenue cycle systems out of necessity, but experts caution to think before jumping.
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Post date: March 11, 2014
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Some states have found practical success in establishing the Affordable Care Act, but what distinguishes their efforts are their unique fit within each state's distinctive political and business climates.
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Post date: March 10, 2014
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A new federal regulatory proposal to ensure adequate insurance networks could help not-for-profit hospitals, Moody's said in a briefing released this week.
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Post date: March 6, 2014
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In case anyone was wondering, the RACs haven't gone away for good. They're just taking a vacation. The Centers for Medicare & Medicaid Services announced a "pause" in RAC audits last month, in preparation for the procurement of the next round of RAC contracts.
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Post date: March 6, 2014
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It's not particularly helpful, but the Centers for Medicare and Medicaid Services has finally addressed the impending ICD-10 delay.
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Post date: April 15, 2014
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It is now official: you must wait until 2015 to use ICD-10 code W6112XA -- struck by macaw. But it's no laughing matter: President Barack Obama has indeed signed the SGR patch legislation, which includes another delay of ICD-10 implementation.
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Post date: April 7, 2014
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Avoiding readmissions penalties has an obvious and direct impact on a healthcare organization's revenue. In an effort to improve patient care and keep your organization's revenue healthy, effective communication is essential.
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Post date: March 20, 2014
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Most healthcare managers recognize the importance of liquidity, but many fail to take the necessary steps to increase it.
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Post date: March 12, 2014
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It has never been clearer: physician practices must be able to code in ICD-10 to bill for services and procedures after Oct. 1, 2014, or they will see a cash flow interruption, additional costs and delayed claims payments. But payers, clearinghouses and vendors can help you.
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Post date: March 11, 2014
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Take note, hospitals: the Centers for Medicare & Medicaid Services has recently announced modifications to the implementation of the controversial "2-Midnight" inpatient admissions policy, as well as releasing the preliminary federal disproportionate share hospital allotments for FY2014.
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Post date: March 4, 2014
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There's still plenty of work to do before the Oct. 1 ICD-10 deadline. A recent study found that only 4.8 percent of physician practices reported significant progress in overall ICD-10 readiness. Hospitals report higher levels, but many are still behind.
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Post date: March 3, 2014
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Conventional wisdom says that too many ICD-10 codes will make it harder for clinicians and medical coders to do their jobs. Some studies suggest a 50 percent or more drop in productivity. But is this an underestimation of the problem?
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Post date: February 17, 2014
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Hospitals can take a deep breath, and rest easier for at least six months. CMS is delaying enforcement of its "two-midnight" policy until after Sept. 30.
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Post date: February 4, 2014
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The Congressional Budget Office has raised the specter that reform to the Medicare physician fee schedule statutory update formula could increase the likelihood that the ACA's Independent Payment Advisory Board mechanism would be triggered potentially resulting in as much as $0.6 billion in Medicare provider cuts.
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Post date: January 30, 2014
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A disconnect occurring in the fraud identification process used by CMS could mean that legitimate claims may be flagged as possible fraud.
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Post date: January 28, 2014
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With the growing complexity and unpredictability of reimbursement, the existing back-end model of managing patients' payments is no longer sufficient. Hospital executives must focus on a proactive approach to collecting payment upfront as well as improving patient education.
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Post date: January 15, 2014
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