Avoiding Prior Authorization Denials

The burden of Prior Authorization According to a recent survey from the American Medical Association (AMA), prior authorization creates an administrative burden for healthcare practices, negatively impacting providers and delaying patient care. The survey also found that providers complete an average of 41 prior authorizations each week and spend an average of two business days […]

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Making a Stronger RCM Team in 2022

A recent survey of U.S. healthcare organizations highlighted declining reimbursements as a top industry challenge. The COVID-19 pandemic changed payer billing guidelines, and reimbursement policies made receiving accurate reimbursement tougher. Reimbursement complications often lead to documentation and coding inaccuracies leading to increased claim denials. The healthcare reimbursement process requires complicated steps and, at each turn, […]

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RCM Strategies to Improve Practice Revenue

Your medical practice revenue is driven, impacted, and influenced by Revenue Cycle Management (RCM) strategies. It includes claims management, patient payments, and your in-house billing workflow. Without implementing these strategies, providers might find it difficult to maintain high levels of clean claims, adjust to an increasing dependence on patient payments, or manage their billing effectively. […]

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Effective RCM Strategies to Collect Maximum Patient Responsibility

Patients’ financial responsibility is on the rise as more patients are choosing high-deductible health plans (HDHP). Increasing patient responsibility is an ongoing trend that does not seem to be slowing down in the near future. Providers report many challenges with responding to growing patient financial responsibility. Given the increased payment responsibility, being able to determine […]

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Highly Neglected Revenue Cycle Processes

For most providers, the revenue cycle process means submitting claims and wait for payer reimbursements. These providers are under the impression that if they submit the claim, it will get paid but that’s not the case. Revenue cycle management includes really crucial processes like provider credentialing and contracting, Benefits verifications, prior authorizations, and out-of-network billing […]

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Effective RCM Strategy to Increase Reimbursements

The Healthcare Financial Management Association (HFMA) defines Revenue Cycle Management (RCM) as all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. Revenue cycle management (RCM) is the financial process related to a patient’s clinical encounter. According to HFMA, a basic role of RCM is to measure how […]

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Revised Accounts Receivable Strategy during COVID-19 Pandemic

Almost every medical practice is facing financial uncertainty as a result of the COVID-19 pandemic. A recent report from Practice Pulse states that while any practice’s primary focus is on caring for patients and keeping their staff safe and healthy, providers have expressed growing concern over reduced practice collections and increased accounts receivables. In this […]

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Increasing Patient Payment Collections in 5 Steps

Most of the practice owners work really hard to understand payer billing and coding guidelines and reimbursement policies. Their intention is to receive accurate insurance reimbursements on time from private as well as government payers. But while making such strategies they miss on the prominent payer i.e., their patients. You will be surprised to know […]

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3 Signs that Show Need of Outsourcing Revenue Cycle Functions

Healthcare providers are under increasing pressure as more and more patients are shifting to value-based care. Providers are already under pressure as they have to deal with declining reimbursements, higher risks, and tighter margins while improving patient care. Due to this, hospitals and physician practices of all sizes are being forced to re-examine their revenue […]

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