The impact of claims denials on the financial health of healthcare
While their hospitals and healthcare centers have long had to deal with claims denials, the number of denied claims continues to rise and payers are showing little inclination to help solve the problem, according to several roundtable participants.
How R1 RCM’s technology-driven solutions address health system challenges
Seeing challenges in labor shortages, shrinking margins and other complexities? Enter technology-driven solutions for revenue cycle management. Read the details in this peer review spotlight.
Beyond automation: Fulfilling your New Year’s resolution for a more efficient revenue cycle
Jonathan Wiik, vice president of health insights at FinThrive, discusses how provider organizations continue to struggle with denials in a time when staff is hard to find.
How to automate revenue cycle operations to improve revenue and reduce resource dependency
Even with an increased focus on automation in the industry, too many revenue cycle operational processes remain highly manual and resource intensive. This is especially true for mid-cycle processes. Manual data entry, such as coding, leaves significant room for error and takes longer to complete, leading to slower reimbursement and ultimately impacting the bottom line. Automation…
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…
Cloudmed, an R1 company, helps health systems get paid for the care they provide
Using one company’s AI platform, health systems will find uncovered funds that can be used to hire essential practitioners, build new facilities and fund outreach programs.
Optimize the cost effectiveness of health through prioritizing the patient experience
Read up on various strategies from several health system executives, including taking full advantage of EHR, reducing expenses, improving patient experience and so forth.
Revenue cycle technology budgets rise to meet need for automation, AI and robotics, says new survey
See five areas where there is room for additional automation according to respondents in a recent survey. Also read about using AI in the revenue cycle and the benefits it brings hospitals and healthcare systems such as dealing with staffing challenges, dwindling margins and increased denial rates.
Most healthcare organizations want to augment current EHR workflows and would consider flexible outsourcing contracts
This pulse survey shows that there is no one-size-fits-all solution for managing today’s revenue cycle challenges. Savvy healthcare organizations know they need a combination of actionable insights and high-performance work teams to be successful.
Clinical audits and denials impact 3% or more of NPR being held in reserve
This pulse survey shows how healthcare organizations are currently tracking health system’s audits and denials from government and commercial payers.