Revenue Cycle Management (RCM)

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 cycle […]

What is Value-Based Care? Unlike traditional ‘fee-for-service care models that link payment to the number and type of services utilized, value-based healthcare is a healthcare delivery model in which providers, including hospitals and physicians, are paid based on patient health outcomes. Value-based care differs from a fee-for-service or capitated approach, in which providers are paid […]

Increased Patient Financial Responsibility In the current healthcare climate, more and more patients are opting for high-deductible healthcare plans resulting in increased patient financial responsibility. Due to high deductible healthcare plans patients has to make large out-of-pocket payments to receive treatment. Few years before physician facilities, and hospitals were not that dependent on patient portions […]

What is Eligibility and Benefits Verification? To receive payments for the services rendered, healthcare providers need to verify each patient’s eligibility and benefits before the patient’s visit. According to RemitData, two of the top five claim denial reasons for the year 2013 were insurance coverage related. With more patients choosing high deductible plans, this figure […]

Streamlined revenue cycle operations ensure the financial stability and growth of your practice. When the healthcare revenue cycle is not managed well, collection efficiency drops, and accounts receivable (AR) days increase. Accounts receivable is at the heart of revenue cycle management, as you get paid faster which results in healthier operations. Streamlining the healthcare revenue […]

Back-office revenue cycle functions include claim submission, payment posting, denials handling & resolution, accounts receivable follow-up, and others. All these functions must be taken care of by billing experts to ensure accurate practice collection. Providers have to spend a lot of time on these back-office functions due to high employee turnover, billing and coding updates, changes […]

In today’s competitive healthcare space maintaining a healthy practice, and revenue is a challenging task. Things became much more complicated in the global corona pandemic as you were already dealing with the administrative burden and rising operating costs and trying to keep your practice profitable. Strategies which will help you in increasing your practice collections: […]

Value-based care is gaining more popularity in the US healthcare system and Accountable care organizations (ACOs) provide the main push for the healthcare industry away from fee-for-service towards value-based care. ACO is a very interesting model for care where groups of doctors, hospitals, and other health care providers voluntarily offer coordinated, high-quality care to patients. […]

Every healthcare provider has a complicated relationship with payers. Healthcare providers are busy in providing treatment to patients and they spend much time with patients and many of the time payers deny payments for the services provided. Providers can prevent claims denials and can ease the denial management that does not come so easy to […]