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

Practice Management News

DoJ Charges Providers in Medicare Fraud Cases, Settles Others


Medicare fraud cases have the potential to drain the federal healthcare program of millions of dollars while also putting beneficiaries at risk of receiving unnecessary or low-quality care. In response, the federal government has ramped up its...

Children’s Hospitals Vulnerable to Uncompensated Care Cuts


Pediatric healthcare providers, especially those practicing in free-standing children’s hospitals, could face serious financial setbacks following upcoming uncompensated care payment reductions as mandated by the Affordable Care Act, a...

CBO: Future Hospital Profitability Requires More Productivity


To stabilize hospital profitability at a six-percent average profit margin by 2025, providers must increase hospital productivity to offset Affordable Care Act provisions to decrease federal reimbursement rates and implement value-based penalties,...

Value-Based Care Spurs Higher Physician Consolidation Rates


More healthcare providers are moving to larger group practices in order to gain access to more resources to effectively implement value-based care and risk-based reimbursement models, according to a recent Datawatch report in Health Affairs....

Using Data Analytics to Decrease Claims Denials, Boost Revenue


Claims denials typically represent one of the largest revenue cycle bottlenecks in most healthcare organizations.  However, slowing down to determine why claims are being denied hasn’t traditionally been an option. The light at the...

WEDI Guide Suggests New Electronic Fund Transfer, ERA Standards


The Workgroup for Electronic Data Interchange (WEDI) recently released a guide that advised all healthcare stakeholders to implement Automated Clearing House (ACH) Electronic Funds Transfers (EFT) and Electronic Remittance Advice (ERA) standards...

How a Small Hospital Developed Lean Supply Chain Management


When hospitals start to dig into how their organizations can reduce healthcare costs without lowering care quality, many run the risk of overlooking several cost-cutting opportunities in their healthcare supply chain management process. But developing...

Reducing Use of Low-Value Services Cuts Healthcare Costs


Providers can substantially lower their healthcare costs by reducing the use of low-value services, even though these services account for a substantially small portion of healthcare spending, according to a recent study by the RAND Corporation...

88% Improve Claims Submissions Using Revenue Cycle Analytics


According to a Navicure survey, medical organizations that used a revenue cycle analytics or business intelligence solution were able to boost performance on key healthcare revenue cycle metrics. About 88 percent of participants reported that...

Epic Systems Tops List of Hospital RCM Technology Users


The healthcare industry finds itself at a turning point in regard to reimbursement. Fee-for-service reimbursement is giving way to alternative payment models that emphasize value over volume, but it remains a financially significant feature that...

Medicaid Program Advances Patient Engagement, Interoperability


At the HIMSS16 conference in Las Vegas, the Centers for Medicare & Medicaid Services (CMS) will be presenting a discussion revolving around how health IT applications could incentivize patient engagement. The panel discussion will incorporate...

Federal Agencies Advance Alternative Payment Models in Medicine


In recent years, the federal government has positioned the healthcare industry to adopt new reimbursement tactics aimed at strengthening pay-for-performance initiatives. These regulations consist of alternative payment models such as bundled...

Providers Squeezed to Integrate Care Management Solutions


At this year’s HIMSS conference and exhibition, Chilmark Research released the 2016 Care Management Market Trends report, which outlines how the market is leaning on healthcare providers to create care management solutions. The report also...

Why Revenue Cycle Management Needs Electronic Data Exchange


More focus on electronic data exchange can potentially save healthcare organizations, hospitals, and health systems $8 billion annually, according to a report from the American Hospital Association (AHA). Rising healthcare costs may...

EHR Documentation Policies Improve Revenue Cycle Management


Revenue cycle management can reap substantial benefits from improved electronic health record (EHR) documentation. But the learning curve is perhaps still too steep to move forward without stumbling. Many physicians consider EHR implementation...

How to Slash Common Healthcare Supply Chain Management Costs


Healthcare supply chain management strategies are generally tied to keeping costs low. But with an apparently broken system still in place, this is not a simple task. Whereas other industries seem to have made supply chain progress, the...

How to Boost Ambulatory Revenue Cycle Management Performance


Ambulatory revenue cycle management is driven by a variety of factors, such as the market growth of Electronic Health Records (EHRs), the meaningful use program, and technological trends. Operating as outpatient healthcare facilities, ambulatory...

Why Hospital Revenue Cycle Demands More Patient Engagement


A lack of technological alignment may cause hospital revenue cycle to dip substantially, according to research from Accenture. Stronger patient engagement efforts and revision of digital health strategies may help hospitals protect their revenue...

Moving Past the “Model Hospital” with Revenue Cycle Management


Many healthcare organizations have recently implemented a new electronic health record (EHR), resulting in a new revenue cycle system.  Through this transition, most of the major EHR vendors insist that you need to implement their “model...

Can Automation Investment Keep Insurance Claim Costs Down?


Hospitals are focusing on various outsourcing endeavors or different manual approaches to maintain a healthy revenue cycle. But is it working as planned? Perhaps only at a steep price. Expenditures for late payment follow-up...


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