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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How to Boost A/R Productivity for Success of Revenue Cycle during Pandemic?

Are you thinking that revenue flow is interrupted due to high accounts receivable? Of course, you need to boost A/R productivity for the Success of Revenue Cycle but you aren’t the only healthcare professional to face revenue loss but you can make a difference particularly during the pandemic. Insurance companies are obliged to pay healthcare […]


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What Is The Prior Authorization Process?

The prior authorization process is seeking “approval from a health plan that may be required before you get a service or fill a prescription for the service or prescription to be covered by your plan”. Most often prior authorization (PA) and pre-authorization are used interchange However, most insurance companies will use the term “prior authorization” instead […]


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How to reduce hospital claim denial rates in 2021?

The recent COVID-19 pandemic has accelerated claim denials from payers. According to a recent analysis, the average rate of claim denial is increasing by 23 percent in 2020 compared to four years ago. Faults related to missing or invalid claim data, which included unspecified billing issues, missing or invalid explanation of benefits, and service not […]


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Efficient RCM Process is the Key to Provider Success in 2021

To overcome the financial impact of pandemic, providers need to measure and focus on an efficient RCM process to get success in 2021. COVID-19 pandemic has a severe impact on the healthcare industry, caused healthcare providers to depend on efficient RCM process to maintain financial stability in 2021 and henceforth. What is RCM Process? Revenue […]


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