Bots Make Claim Status Inquiry More Efficient for Avera Health
Robots in healthcare do not have to be large human-like machines that replace providers. But bots embedded in software applications can be a key tool for reducing the burden of mundane, common tasks,...Sponsored by Olive
Using Artificial Intelligence to Improve the Hospital Revenue Cycle
Each year when they draft their budgets, hospital CFOs and other financial leaders are challenged to find ways to cut costs while maintaining high-quality services. Fewer dollars are flowing into...Claims Management Automation Progresses, But Opportunities Remain
Electronic claims management adoption by plans and providers is at or above 80 percent for three of the seven transactions analyzed in the most recent CAQH Index. The CAQH 2018 Index showed adoption...40% of Revenue Cycle Leaders Don’t Discuss Charge Capture Regularly
Over three-quarters (78 percent) of revenue cycle leaders at acute care organizations agreed charge capture is essential to an organization’s success, yet most leadership teams only discuss...Court Orders HHS to Eliminate Medicare Appeals Backlog by 2022
HHS must eliminate the Medicare appeals backlog at the Administrative Law Judge (ALJ) level by the end of the 2022 fiscal year, according to a recent court order. Judge James E. Boasberg of the US...3 Strategies to Minimize the Burden of Prior Authorizations
Prior authorizations, or prior approvals, are strategies that payers use to control costs and ensure their members only receive medically necessary care. The cost-control process requires providers to...Medicare Advantage Plans Overturn 75% of Their Own Claim Denials
A new report from the HHS Office of the Inspector General (OIG) reveals “widespread and persistent problems” related to prior authorization and claim denials in Medicare Advantage. Using...Sponsored by symplr
States Look to Streamline Payer Enrollment, Cut Provider Paperwork
Healthcare is a waiting game, with the most common example being the patient waiting room. But patients aren’t the only healthcare stakeholders left waiting. Healthcare organizations oftentimes...Sponsored by symplr
How Automating Payer Enrollment Reduces Time to Reimbursement
Manual claims management processes significantly slow down time to reimbursement. However, payer enrollment services can help healthcare organizations digitize the key claims management step to reduce...RCCH Uses Predictive Analytics to Boost Claim Denials Management
Predictive analytics are key to implementing an effective and efficient claim denials management strategy that tackles the right denials at the right time, according to the Vice President of Revenue...When Claims Reimbursement Doesn’t Cover Healthcare Innovation
Implementing healthcare innovations that improve care quality is key to boosting patient experience and care quality, but what happens when claims reimbursement doesn’t cover the use of the...HHS to Clear Medicare Appeals Backlog by 2022, Court Docs Show
HHS is making significant progress with eliminating the growing Medicare appeals backlog, according to recent court documents. The federal department projects Medicare to clear the backlog by the 2022...Medicaid Could Save $4.8B Through Electronic Claims Management
State Medicaid programs are significantly lagging with the adoption of fully electronic claim submissions, claim reimbursements, prior authorizations, and other claims management processes, according...CAQH Stresses the Importance of Prior Authorization Automation
CAQH’s Committee on Operating Rules for Information Exchange (CORE) is urging a group of industry leaders to encourage prior authorization automation as part of their efforts to improve the...Sponsored by RevSpring
