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

Revenue Cycle Management

Patient Financial Responsibility Not Owed Top Medical Debt Issue

April 19, 2017 - A recent report from the think tank Frontier Group and the US Public Interest Research Group (PIRG) Education Fund may spell trouble for providers attempting to collect overdue patient financial responsibility either internally or through a debt collection agency. Researchers reported that 63 percent of consumer complaints about medical debt collections stated that the debt was never owed,...


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Patient Financial Responsibility Not Owed Top Medical Debt Issue

by Jacqueline Belliveau

A recent report from the think tank Frontier Group and the US Public Interest Research Group (PIRG) Education Fund may spell trouble for providers attempting to collect overdue patient financial responsibility either internally or through a debt...

Credit Card On File Program Key To Patient Collections Success

by Jacqueline Belliveau

Implementing a credit card on file program boosted patient collections and reduced accounts receivable by 28 percent in six months at Orthopaedics & Rheumatology of the North Shore, a four-physician specialty practice in Illinois. Consumers...

Boost Healthcare Competition to Drive Down Prices, Up Quality

by Jacqueline Belliveau

The lack of healthcare competition stemming from recent healthcare merger and acquisition trends resulted in higher prices and lower care quality, industry experts recently argued in a Carnegie Mellon University’s Heinz College white paper....

Healthcare Supply Chain Issues Cause VA Center Director Change

by Jacqueline Belliveau

The VA recently removed its medical center director from his position and temporarily reassigned him to administrative duties after the Office of Inspector General (OIG) reported several patient safety concerns stemming from healthcare supply...

TN Law Aims to Make Payer Contract Management More Predictable

by Jacqueline Belliveau

Earlier this week, Tennessee Governor Bill Haslam signed the Provider Stability Act into law, which intends to increase transparency and accountability for payer contract management. Effective Jan. 1, 2019, the law will require payers in the...

Medicaid Expansion Linked to $5M Annual Hospital Revenue Boost

by Jacqueline Belliveau

Hospital revenue in Medicaid expansion states increased by $5 million annually per facility after states chose to extend Medicaid coverage to more individuals, a recent Robert Wood Johnson Foundation and Urban Institute report showed. The study...

Healthcare Mergers May Face New Federal Rules Under SMARTER Act

by Jacqueline Belliveau

In a 16 to 20 vote earlier this week, the House Judiciary Committee passed the Standard Merger and Acquisition Reviews Through Equal Rules Act (SMARTER Act), which could affect how federal antitrust agencies evaluate healthcare mergers and acquisitions....

Healthcare Consumerism Challenges Primary Care Business Models

by Jacqueline Belliveau

Primary care providers are facing significant and oftentimes conflicting challenges in response to two major healthcare trends: value-based purchasing implementation and the rise of healthcare consumerism, a recent Journal of Internal Medicine...

Physician Compensation for Specialists 45.6% More than for PCPs

by Jacqueline Belliveau

According to a recent Medscape survey, physician compensation for specialists was 45.6 percent more than what primary care providers earned in the past year. The survey of over 19,200 physicians in 27 specialists uncovered that the average physician...

Healthcare Costs Rise With Regional Post-Acute Care Variations

by Jacqueline Belliveau

Despite receiving similar post-acute care services overall, rural hospital patients tend to undergo more skilled nursing facility treatment than home health care versus urban hospital patients, contributing to higher healthcare costs, according...

Lean Primary Care Improves Physician Productivity, Costs

by Jacqueline Belliveau

A recent American Journal of Managed Care study showed that implementing a Lean primary care model resulted in operational cost reductions, physician productivity improvements, and higher patient satisfaction scores. “Our findings indicate...

Is Radiation Overuse Contributing to Higher Healthcare Costs?

by Jacqueline Belliveau

Oncologists could have saved over $164 million in healthcare costs if they had adhered to clinical guidelines and prescribed shorter radiation treatment for some breast cancer patients, a recent Journal of Oncology Practice study revealed. Only...

IL Supreme Court Maintains Non-Profit Hospital Tax Exemption

by Jacqueline Belliveau

The Illinois Supreme Court recently legally voided an appellate court’s decision that non-profit hospital tax exemption was unconstitutional. In Illinois, non-profit hospitals qualify for property tax exemption if the value of all charitable...

Physician Shortage Projected to Grow to 104K Providers by 2030

by Jacqueline Belliveau

The physician shortage is projected to grow to up to 104,900 providers by 2030, new research from the Association of American Medical Colleges (AAMC) revealed. The projected physician shortage increased from an estimated shortfall of up to 90,000...

Hospitals Seek Independent Docs for Referrals, Healthcare Revenue

by Jacqueline Belliveau

A recent SCI Solutions survey found that 58 percent of independent providers do not have one or more preferred referral hospital partners, suggesting a major healthcare revenue opportunity for health systems and hospitals. Out of the 549 independent...

52% of Practices Use Various Reminders to Stop Patient No-Shows

by Jacqueline Belliveau

To prevent patient no-shows, a recent Medical Group Management Association (MGMA) poll showed that providers are using a variety of communication methods to protect their healthcare revenue from missed appointments. The recent survey of 1,279...

Top 4 Claims Denial Management Challenges Impacting Revenue

by Jacqueline Belliveau

For most healthcare organizations, claim denials are a normal, if not a frequent, occurrence. While very few can boast that their denial rates are close to zero, many providers face a number of challenges with implementing an effective claims...

NH Judge Rejects CMS FAQs Clarifying Medicaid DSH Payments

by Jacqueline Belliveau

A district court in New Hampshire recently prohibited CMS from enforcing two Frequently Asked Questions (FAQs) that clarified how private payer and Medicare reimbursements paid to hospitals for dually-eligible Medicaid patients would be used...

Healthcare RCM, Patient Collections Solutions Launch at HIMSS17

by Jacqueline Belliveau

ORLANDO - With over 40,000 healthcare stakeholders milling around Orlando’s Orange County Convention Center for HIMSS17, big and small vendors were eager to show off the latest and greatest products in healthcare revenue cycle management....

Health Systems, Physicians See Significant Revenue Losses in 2015

by Jacqueline Belliveau

Both integrated healthcare systems and private physician practices saw operating losses in 2015, according to a revenue cycle management survey conducted by the American Medical Group Association. Integrated healthcare systems saw an operating...

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