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

Revenue Cycle Management Interviews

Paperless Medical Billing Key to Boosting Patient Collections

by Jacqueline LaPointe

In the age of smartphones, tablets, and other technologies that put information literally in the palm of our hands, why do doctors still rely on paper to reach their patients for medical billing purposes? That was the question Max Tselevich...The digital revolution at The Doctor allowed patients to use technology to book appointments, check-in, access their medical records, request prescription refills, and update their patient portal information. But the technological advanceme...

Revenue Cycle Management Integration Boosts the Bottom Line

by Jacqueline LaPointe

When you ask a provider which EHR system he uses, you expect to hear a single vendor, such as Epic, Cerner, or MEDITECH. But when you inquire about a provider’s revenue cycle management system, you are likely to get a laundry list of ...“We've been watching Cerner and their revenue cycle product to see how it matured, developed, and stabilized over the course of time,” he said. “We made the decision about three years ago to re-visit it. We did a forma...

How Hospitals Bring in Revenue Through the Healthcare Supply Chain

by Jacqueline LaPointe

The healthcare supply chain is a cost center for provider organizations of all sizes. Through the supply chain, healthcare organizations spend money on the items and supplies they need to deliver the services that bring in revenue. As a res...

WA Makes Healthcare Price Transparency Consumer-Friendly

by Jacqueline LaPointe

How much does a knee replacement surgery cost at MultiCare Auburn Medical Center in Auburn, Washington versus St. Anthony Hospital in nearby Gig Harbor? Does EvergreenHealth Medical Center in Kirkland deliver the highest value birthing expe...“A lot of them have experiences in other states, so they're familiar with the way intake and submission work,” she added. “They've been through the process of the state mandating the submission. It actually was a f...

Quantifying Financial Distress to Stop Hospital Bankruptcy, Closure

by Jacqueline LaPointe

More healthcare organizations will face financial troubles, and possibly a hospital bankruptcy or closure, in the coming years as the healthcare industry undergoes major changes. Changes that will result in lower reimbursement rates, more c...The Z-score is a weighted composite score of four types of ratios, Langabeer and his research team explained. The score accounts for financial leverage, profitability, liquidity, and capital structure, which can all be found on hospital bal...“The variable X1 represents net working capital (e.g., current assets less current liabilities) ÷ total assets. The variable X2 represents retained earnings ÷ total assets. Variable X3 is earnings before income taxes &di...“But fundamentally CFOs needs to get involved with figuring out how to manage their business differently. How do we restructure our service lines? How do we partner with different facilities? How do we get better referral networks fro...

When Should Providers Consider a Strategic Hospital Acquisition?

by Jacqueline LaPointe

For many small hospitals, remaining independent as the healthcare industry hurdles toward value-based purchasing, population health management, and other transformations is a source of pride even if the organization has one foot in the fina...“Long-term, that's worse for their patients and for their communities,” he continued. “They wait until they are running out of cash and they start looking like the Alamo. You don't want to be in a position where Sa...

Finding a Revenue Cycle Management System for Post-Acute Care

by Jacqueline LaPointe

Post-acute care has become a major focus as providers, payers, and policymakers attempt to cut healthcare costs and improve long-term patient outcomes. However, the revenue cycle management space is dragging its feet when it comes to making...Revenue cycle management systems lack the sophistication to manage medical billing across several post-acute care facilities because they were designed for other healthcare facilities, Morris elaborated. “A lot of the products that ar...

A Provider-Sponsored Health Plan Is A Hospital’s Natural Next Step

by Jacqueline LaPointe

Many hospitals and health systems are bypassing the ultimate opportunity to gain greater control of the outcomes and costs of their patients. That opportunity is developing their own provider-sponsored health plan, according to Geisinger He...“There's a lot of different forms of risk-taking that can occur,” he elaborated. “You can think about it on a final payment basis. You could think about it on a total cost of care basis. The other would be like what we...

Providers Investing in Home Health to Prepare for Aging Population

by Jacqueline LaPointe

Faced with the pressure to reduce healthcare costs as the elderly population rapidly grows, providers plan to shift elder care from hospitals and skilled nursing facilities to the home, healthcare experts explained. According to CMS and Cen...

Quality Improvement Projects Save Children’s Hospitals Millions

by Jacqueline LaPointe

Care quality improvements require hospitals to invest their money, time, and staff. The investment may be large, but for two children’s hospitals it paid off, saving the organizations millions and reducing costly accidents and unneces...“One of the very first things we did was provide asthma control tests, which is a validated tool to screen for asthma control,” he said. “Our goal was to provide that at each visit in which we saw a patient with asthma reg...“It started by trying to measure harm. We didn’t have any idea how often that was happening. So, the first thing was to create a system for how we were going to categorize harm and then start to measure that,” he said. The...

Healthcare Mergers, Increased Access to Boost Medical Costs 6%

by Jacqueline LaPointe

PwC’s Health Research Institute (HRI) predicts medical costs for employers to grow 6 percent in 2019 as healthcare mergers and more convenient care access options drive up healthcare costs and utilization. The medical cost trend is co...Healthcare mergers and consolidation will not help the healthcare industry drive down medical costs to a sustainable rate, revealed the HRI analysis of the employer-based market, which covers approximately one-half of non-elderly Americans....This boost in healthcare utilization will temporarily increase costs, Gniewek explained. “The shocker on the inflator side is really the care anywhere factor and the idea that we wanted to make healthcare easier. But whenever you make...

Automated Physician Queries Improve Clinical Documentation at WMHS

by Jacqueline LaPointe

Accurate claims reimbursement hinges on complete clinical documentation, and therefore, quick responses to physician queries regarding medical record documentation and coding. This is especially true in Maryland’s unique hospital reim...“This whole process usually took anywhere from three days to sometimes up to three or four weeks,” Davidson elaborated. And physician query response rates hovered between 62 and 65 percent, impacting several of the health system...

Giving GA Hospitals Healthcare Cost Data to Lowering Spending

by Jacqueline LaPointe

With claims reimbursement rates falling and competition among healthcare organizations intensifying, hospitals are calling on their providers to increase efficiency and reduce healthcare costs for each admission. So, what do providers need ...But merely dumping a plethora of healthcare cost and quality data into a provider’s hands was not the route Wylie aimed to take. He emphasized how providers should be able to access healthcare cost data that helps them choose the most...

Payment Plans Key to Collecting Patient Financial Responsibility

by Jacqueline LaPointe

With the rise in popularity of high deductible health plans, hospitals are no longer waiting on just payers to collect what is owed to their hospital or practice. Patients have become a major revenue source, but hospitals are struggling to ...“For example, when we looked across the spectrum as far as collection performance goes, we were collecting approximately 5 percent on self-pay and about 30 percent on the balance after insurance. Not great outcomes.” With patien...

Addressing Productivity, Labor to Bend the Healthcare Cost Curve

by Jacqueline LaPointe

From alternative payment models and value-based purchasing to artificial intelligence and data analytics tools, the healthcare industry is transforming how care is delivered and paid for to reduce constantly rising medical costs. While paym...

“Just the Beginning” of Healthcare Price Transparency, Verma Says

by Jacqueline LaPointe

Requiring hospitals to post a list of their standard charges online is just the beginning of the push for increased healthcare price transparency by CMS, explained the federal agency’s Administrator Seema Verma. “As people are p...In addition to general healthcare price transparency questions, CMS is also seeking comments on understanding the out-of-pocket costs for patients with Medigap coverage. The RFI echoes a recent push for healthcare price transparency informa...

Gaining Visibility into Healthcare Workforce Management Cuts Costs

by Jacqueline LaPointe

If it takes a village to raise a child, then it may take an entire city to operate a health system. From executives and clinicians to IT managers and front desk staff, healthcare workforce management involves hundreds to thousands of employ...“There's been so much consolidation that they don't have a clear picture of their entire workforce,” he remarked. “They may have the data in four different databases or they may have time management in one system, ...

RFID, Smart Cabinets Improve Hospital Supply Chain Management

by Jacqueline LaPointe

From EHR systems and revenue cycle management tools to data analytics and online patient payment options, hospitals and health systems are on the journey to automating all aspects of the healthcare experience. However, the hospital supply c...

Real-Time Insights into Nursing Workflow Maximizes Productivity

by Jacqueline LaPointe

An elderly patient presses the nurse call button to get assistance with standing up and using the toilet, while another patient in the next room presses the button to get help with changing the TV channel. Further down the hall, lights turn...“From their room, the patient is able to call their nurse directly without going through a unit secretary or a unit clerk,” Bedgood explained regarding the new system. “They can hit a button and it will ring a phone in the...

OR Efficiency, Machine Learning Boosts UCHealth’s Revenue by $10M

by Jacqueline LaPointe

Moving from traditional block scheduling for the operating room (OR) to more of a service-based system that used machine learning maximized OR efficiency and increased revenue by $10 million across UCHealth’s University of Colorado Ho...But not all the surgeons needed that eight-hour block. “Some people will use four-hour chunks and only operate half the day,” he said. The hospital needed a service-based approach that was more flexible than block scheduling and...“What that meant was the operations team and surgeons would have to sit down and stare at this data and try to make sense of it,” he continued. “They had the data, but it was all about what happened in the past and not abo...

X

Join 30,000 of your peers and get free access to all webcasts and exclusive content

Sign up for our free newsletter:

Our privacy policy

no, thanks

Continue to site...