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

Revenue Cycle Management

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...

Reducing Use of Low-Value Services Cuts Healthcare Costs

by Jacqueline Belliveau

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

by Jacqueline Belliveau

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...

Healthcare Costs Concerns Impact Provider Rationing Behavior

by Jacqueline Belliveau

It is not uncommon to hear patients say that healthcare costs are going up, especially as more individuals enroll in high-deductible health plans. But, some providers oftentimes question if they should be responsible for helping to control costs....

74% of Providers See Increased Patient Financial Responsibility

by Jacqueline Belliveau

A recent report from InstaMed found that 74 percent of healthcare providers reported an increase in patient financial responsibility in 2015, which has prompted healthcare revenue cycle management strategies to focus more on consumers. “With...

Patient Billing Challenges Revenue Cycle Management

by Catherine Sampson

Patient payment and billing are significant revenue cycle management challenges that should not be ignored.  According to a recent survey conducted by Navicure, 63 percent of participants recognized that patient payment processes were “a...

5 Ways to Cut Costs through Hospital Revenue Cycle Management

by Catherine Sampson

As healthcare costs continue to rise, hospital revenue cycle management has become an important focal point for providers. Healthcare expenditures in the US are projected to reach $4.4 trillion by 2018, according to an article in The American...

5 Most Common Hospital Revenue Cycle Management Challenges

by Catherine Sampson

Since the Affordable Care Act, the task of hospital revenue cycle management has changed significantly. Between ICD-10, MACRA, and accountable care, it has become a hospital’s best interest to have an effective revenue cycle management...

Top 5 Ways to Optimize Healthcare Revenue Cycle Management

by Vera Gruessner

Revenue cycle management remains relatively elusive in the new healthcare landscape, as new regulations and reforms have led the industry to evolve and left many hospitals scrambling to keep their revenue strong in a value-based care reimbursement...

41% of Providers, Payers Adopt Value-Based Care Reimbursement

by Vera Gruessner

With the push from private and commercial health payers along with federal agencies to adopt value-based care reimbursement strategies, many more healthcare providers seem to have begun contracting through pay-for-performance arrangements. A...

Defining the Top 10 Terms of Healthcare Revenue Cycle Management

by Catherine Sampson

In some cases, definitions for terms and acronyms related to healthcare revenue cycle management can come across as fairly straightforward. Other times, they can sound more like a foreign language. A healthcare professional may find it difficult...

How Automation Technology Could Cut $8 Billion in Healthcare

by Vera Gruessner

One method for better managing the revenue of a hospital and reducing wasteful spending is to reduce manual administrative processes and incorporate automation technology. The 2015 CAQH Index shows that the healthcare industry is needlessly spending...


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