International member spotlight: Aleetta Baby uses certification to enrich her career and look to the future
Aleetta Baby’s enthusiasm for her work is evident in her dedication to learning new skills. “I enjoy working in revenue cycle management because each day presents a new learning opportunity, task or challenge.” Baby, revenue cycle management financial analyst at Sheikh Shakhbout Medical City (SSMC) in Abu Dhabi, has completed her Certified Revenue Cycle Representative (CRCR) certification…
Vanderbilt Health harnesses data to improve revenue cycle management
Close to half of healthcare finance professionals say in a survey that their organizations are experiencing a severe shortage of revenue cycle management (RCM) talent — and many are exploring automation as a way to keep RCM operations working properly. It’s a move that Vanderbilt Health in Nashville, Tennessee, made just prior to the pandemic — and…
New federal rule aims to eventually ease prior authorization processes
CMS is seeking to improve the prior authorization process in government programs such as Medicare Advantage (MA) and Medicaid, although the core provisions would not begin until 2026. The agency this week updated a Trump administration proposed rule with new proposals to “improve patient and provider access to health information and streamline processes related to prior authorization…
How healthcare organizations can defend against financial hazards in 2023
What are the most critical strategies to steer healthcare organizations in the direction of financial stability in the following year and beyond? A couple tips include reducing bad debt and accessing external benchmarks for supply pricing.
HHS says the co-provider requirement for good-faith estimates is being tabled indefinitely
The U.S. Department of Health and Human Services has given hospitals and other healthcare providers a break on enforcement of a looming requirement for co-providers to be included on good-faith estimates (GFEs) furnished to uninsured patients. HHS announced in an updated FAQ that it will continue to exercise “enforcement discretion” instead of potentially penalizing providers starting Jan.…
Utilization Review: 5 Reasons Hospitals Lose Revenue
An effective utilization review program must revolve around the right management and processes as well as communication among teams.
Healthcare News of Note: Trust in local healthcare systems’ handling of the pandemic increased during a 28-month time span
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Trust increased in healthcare providers’ handling of the pandemic when compared with the government, working-age adults suffer financial setbacks after admission for traumatic injury, and deaths by stimulants have increased.
CareCredit healthcare credit card provides flexible payment options for both patients and healthcare providers
Read about one company's payment solution that gives patients a way to pay for out-of-pocket healthcare costs while enabling health care organizations to receive payment for services within two business days.
Revenue Cycle Insights newsletter: Medicare outpatient payment bump less than first appears
On the surface, CMS is granting Medicare outpatient care a 3.8% payment increase, but a variety of negative adjustments that will vary by provider are going to cut into the net gain. Senior Editor Nick Hut breaks it all down. Also, Vanderbilt Health is reaping gains from its earlier adoption of automation technology in revenue…
David Johnson: Rewiring healthcare’s smartest professionals (Hint: It’s not physicians)
I won’t keep you in suspense. Healthcare’s smartest professionals are the tens of thousands of individuals who populate its revenue cycle operations. Revenue cycle professionals determine how much payers fork out and how much providers receive for healthcare treatments. They constitute the beating heart of the nation’s transactional healthcare system. Their ingenuity knows no bounds.…