Posts Tagged: revenue cycle management

Doing More with Less, The Value of Automated Claims Status Reporting

Automating claims statusing takes the manual and tedious and helps focus precious resources on claims that matter. Still, it’s not just THE solution to transform hospital business offices. It’s A sophisticated tool forward-thinking hospitals should have in their business office tool kit, to maximize productivity and achieve the revenue cycle results necessary to continue to offer excellent healthcare.

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Four Tools for More Effective Claims Management, Part 1: Predictive Analytics

Predictive models can accurately stratify claims and allow hospitals and health systems to think differently about which accounts to collect (and how) and which to outsource. With these models, you can predict with great confidence which claims are worth very little money, regardless of how much effort is put forth, providing hospitals and health systems with an opportunity to change the claim management paradigm.

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Are You Prepared to Engage Your Patients?

Providers face a myriad of challenges to the revenue cycle. From shrinking reimbursements and bundled payments to the eventual roll-out of ICD-10, the need to optimize revenue cycle performance continues to increase. But many (if not most) of these challenges impact the well-established relationship that exists between providers-payers. Providers have processes and systems in place to engage commercial and government payers in the claims resolution process (albeit not always optimized). They are much less prepared to turn their focus toward engaging patients in the payment process.

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Juggling the Revenue Cycle

Every now and then I think revenue cycle executives are actually circus jugglers in disguise. First, we get the ICD-10 plate spinning on its stick — push it harder to keep it stable on the stick. Introduce high deductible health plans and rapid escalation in patient receivables – add another plate and get it spinning. Let’s add more contract complexity and push denials and underpayments – add another plate, get it spinning. ICD-10 get’s pushed out – that plate needs a push. Exchanges open and high deductibles get even more pervasive – that plate needs to be spun again. Oh, here come IRS 501r regulations – new plate, this one likely to stay around for a long time. Maybe that’s the end. Nope…

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