Existing utilization review (UR) paradigms are no longer suitable for addressing the changing commercial payer denial landscape and the obligations placed on case managers as a result of...
In a landscape marked by greater financial responsibility shifting to more consumer-oriented patients and the cost of healthcare rising, healthcare providers must actively engage patients...
Medical professionals spend more money billing and collecting than in any other industry. Even with powerful management software and trained employees, maximizing profit is a challenge. The...
"How are we getting paid compared to how we should be getting paid?" Though it may seem like a straightforward question, its answer is actually quite complex. This whitepaper...
Stemming from an annual survey process, this report describes the performance management realities, priorities and challenges of healthcare CFOs and other senior finance executives, offered...
As health care shifts from volume to value, a trusted RCM services provider can work with healthcare providers to prepare for regulatory changes, so they can optimize reimbursements while...
The pervasive problem of revenue leaks continues to squeeze already compressed margins. With a tremendous upside to once-and-for-all finding and fixing root causes and preventing new...
Revenue loss due to missed charges occurs more frequently than most hospital executives would want to admit. These missed revenue opportunities end up costing health systems millions of...
Patients need convenience. Providers need secure, flexible solutions to educate patients on their changing financial responsibilities and promptly collect what's owed. This paper...
To avoid costly backlogs and lost revenue, providers need to reduce their overall denial rate, zero in on what's really driving it and where there's the greatest opportunity to...
Beyond Dollars and Cents: A Closer Look At ValueBeyond the expected improvement in specific metrics, many organizations that outsource RCM with a trusted and certified partner are seeing several ancillary benefits of such agreements.
Care Collaboration Success for Improved OutcomesThe nature of our healthcare ecosystem has been one of siloed care. Rarely do payers, providers and local resources come together with the patient's well-being prioritized as a unifying mission. Read how these organizations are getting it right.
Debunk the Myth: Outsourcing Doesn't Mean Losing ControlWith shifts in payer mixes and reimbursement structure, the margin of reimbursement has been shrinking steadily over the last five years. How do revenue cycle leaders navigate payment reform while maintaining stable business office operations?
Healthcare mergers and acquisitions in 2016: Running listWhile 2015 was a record-breaking year in healthcare mergers and acquisitions, 2016 saw more change as organizations across the industry adjust and adapt to the evolving financial landscape.
Clinical Quality Measures 101Although quality-reporting programs such as meaningful use provide incentives to help providers implement and use electronic health records (EHRs) to collect and report on clinical data, practices often need help deciding what data to collect, which measures to report ...
Credible, Defensible EstimatesIn healthcare, every interaction with the patient matters. Especially in today’s environment of continuous improvement, efforts have been concentrated on coordination among providers, the patient care experience and quality outcomes – all laudable goals.
