Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Features

Top Revenue Cycle Management Vendors and How to Select One

As value-based reimbursement models, such as the upcoming Quality Payment Program, break down the walls between care quality and healthcare payments, more providers have set their sights on implementing vendor-sponsored revenue cycle management solutions that can manage the integration of reimbursement and value. The healthcare revenue cycle management software and services industry is projected...


More Features

What a Trump Presidency Means for Value-Based Care and the ACA

Love it or loathe it, the United States is headed for four years of drastic policy changes under a Donald Trump administration, giving lawmakers another good chance to repeal, replace, or revise the Affordable Care Act. The landmark healthcare...

How to Maximize Revenue with Improved Claims Denials Management

Claims denials may be a part of life for healthcare revenue cycle managers, but a prevention-focused denials management strategy may be able to significantly reduce the number of times billing staff are faced with unpaid claims. Recent healthcare...

CMS Timelines for Stage 3 Meaningful Use, MACRA Implementation

For Medicare providers, CMS has set the pace for quality improvements and healthcare payment reform through Stage 3 Meaningful Use and the Quality Payment Program (under MACRA implementation). The programs are designed to put providers on track...

Understanding the Value-Based Reimbursement Model Landscape

In January 2015, the Department of Health and Human Services (HHS) announced that it intends to link half of all traditional Medicare payments to a value-based reimbursement model by the end of 2018.  The announcement, followed...

Key Ways to Boost Collection of Patient Financial Responsibility

Ever since the Affordable Care Act was passed in 2010, more providers are experiencing a shift in healthcare revenue sources, especially as patient financial responsibility increases. While hospitals and physician practices traditionally communicated...

Preparing the Healthcare Revenue Cycle for Value-Based Care

Not only do value-based care models aim to make healthcare providers more accountable for the services they provide to patients, but they are also designed to shift financial accountability away from payers to healthcare organizations. However,...

What Is Healthcare Revenue Cycle Management?

While hospitals, small practices, and larger healthcare systems are known for saving lives and treating patients, every healthcare organization needs to develop successful processes and policies for staying financially healthy. That is where...

What Is Value-Based Care, What It Means for Providers?

Value-based care is a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness. This form of reimbursement has emerged as an alternative and potential...

Using Revenue Cycle Analytics for Effective Value-Based Care

The hospital industry has been experiencing a number of challenges in recent years due to the payment reforms coming from the Centers for Medicare & Medicaid Services (CMS) and commercial health payers. There has been a much greater push...

What We Know About Value-Based Care Under MACRA, MIPS, APMs

The Medicare Access and CHIP Reauthorization Act of 2015 has many parts tied to Medicare and other federal health plan beneficiaries, but first and foremost it is a bill that brings an end to the sustainable growth rate and a beginning to new...

Key Ways to Improve Claims Management and Reimbursement in the Healthcare Revenue Cycle

Reimbursement is changing in healthcare. Even before elements of the Affordable Care Act began to go into effect, a growing focus on value- based care versus volume has led many healthcare organizations and providers to consider accountable...

Why Healthcare Needs Value-Based Supply Chain Management

Healthcare supply chain — the holistic flow of relationships between suppliers and customers — is about efficiently delivering low cost care as goods and supplies, such as a pair of doctor’s gloves, move from point of purchase...

21st Century Cures Act Rekindles Information Blocking Debate

HealthITAnalytics While primarily billed as a much-needed influx of funding for precision medicine, the 21st Century Cures Act is poised to do much more for healthcare than it appears on the surface. In addition to adjusting drug development rules for pharmaceutical...

How Payers Can Improve HEDIS Quality Measure Performance

HealthPayerIntelligence HEDIS quality measures have a significant role in the healthcare industry regarding closing gaps in care and decreasing the use of costly acute care through preventive services. By placing a greater focus on value-based care and quality improvement...

Balancing Patient Portal Privacy and Access for Pediatric Care

PatientEngagementHIT Patient portals are an important regulatory requirement, with industry professionals touting their ability to better engage the patient and help all participating parties manage patient health. While pediatric and adult patients tend to use the...

State Data Breach Notification Laws Critical to Healthcare Orgs

HealthITSecurity The HIPAA Privacy, Security, and Data Breach Notification Rules require covered entities and business associates to take great care with how PHI is handled, stored, and transferred. Should patient data become compromised, healthcare organizations...

The Benefits and Challenges of Telehealth for Specialists

mHealthIntelligence Telehealth’s potential has always revolved around bringing the doctor to the patient, no matter where each are located. While the concept most often applies to acute or primary care providers, its success is often more visibly demonstrated...

Using Risk Scores, Stratification for Population Health Management

HealthITAnalytics Population health management requires providers to maintain a delicate balance between taking a long view of generalized patient trends and focusing personal attention on the individual and the distinctive circumstances that will influence her...

Why Application Programming Interfaces Are Key for Healthcare

HITInfrastructure Healthcare organizations seeking to create interoperability between internal apps, EHRs, and other data exchange tools, are increasingly turning to application programming interfaces (APIs) to manage the flow of information between disparate...

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