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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Visibility key to efficient revenue cycle management

 
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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As payers and employers put pressure on providers to assume more financial risk, providers are struggling to assess the impact of the risk they have already assumed.
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Post date: July 25, 2014
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With patients paying more out-of-pocket costs and exchanges increasing the number of plans providers deal with, having financial counselors in a practice may become a necessity.
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Post date: July 23, 2014
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Medicare announced Friday that it was revising rules intended to prevent the agency from paying twice for the same prescriptions for seniors receiving hospice care. The drug categories in question were identified in a 2012 investigation by the HHS inspector general.
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Post date: July 21, 2014
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If we don't fundamentally change the way we pay for healthcare, we won't change the economic principles that continue to drive the rapid growth in healthcare spending. Let's pay physicians and hospitals based on the health problems their patients have.
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Post date: July 15, 2014
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Hospices can now lose Medicare payments if they don’t file cost reports, and yet, because there are no penalties for inaccurate reporting, there is little motivation to spend much time on them.
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Post date: July 11, 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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Last month the Centers for Medicare & Medicaid Services published its proposed rule to update the Medicare Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center Payment System rates and policies for calendar year 2015. Here's what you need to know.
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Post date: August 6, 2014
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If hospitals want to survive the new healthcare environment, they can't simply brace themselves for the Centers for Medicare & Medicaid Services' new reporting measures -- they must proactively improve their quality scores.
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Post date: July 30, 2014
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Medicaid beneficiaries deserve the same access to healthcare services and products as people with commercial insurance or Medicare. But since Medicaid pays doctors and hospitals 27 to 65 percent less than commercial health plans, it makes it awfully difficult for providers to be payer agnostic.
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Post date: July 23, 2014
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Even though it has not been determined what impact the health insurance exchanges will have on hospital finances, there are steps hospitals can take to increase the likelihood of positive effects on their revenue cycles.
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Post date: July 22, 2014
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Even though it has not been determined what impact the health insurance exchanges will have on hospital finances, there are steps hospitals can take to increase the likelihood of positive effects on their revenue cycles.
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Post date: July 22, 2014
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Even though it has not been determined what impact the health insurance exchanges will have on hospital finances, there are steps hospitals can take to increase the likelihood of positive effects on their revenue cycles.
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Post date: July 22, 2014
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Facing threats to net revenue, most healthcare organizations have embarked on massive cost reduction initiatives. Unfortunately, the first tactic for many of these initiatives continues to be a "tried and true" approach which is often ineffective -- operational benchmarking.
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Post date: July 21, 2014
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