Health IT Outcomes: The Patient, the Clinicians, the Payer, and the Hospital Encounter

Dr. Ronald HirschMay 8, 2019

While efforts continue to be made to improve the quality and efficiency of care provided to patients in a hospital (this includes many of the qualifying payment programs being tested by governmental and private payers), the industry cannot overlook how patients view their financial obligations and how their financial situation impacts ...

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Becker's Hospital Review: Why Prevention is the Best Medicine for Clinical Denials

Becker's Hospital ReviewApril 29, 2019

Clinical denials are a fact of life for hospitals. Providers must contend with a number of government audits conducted by several different organizations. On the private payer side, hospitals must comply with complex approval processes related to prior authorizations, admission status and medical necessity.

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5 Ways Providers Can Improve Front-End Processes and Reimbursement

Richard Lopez del RinconFebruary 14, 2019

In order to maintain financial stability in an ever changing industry, healthcare providers need to develop a better understanding of the impact front end processes have on the revenue cycle. With this in mind, let’s take a look at five ways providers can drastically improve office flow and maximize reimbursement by bringing the front end back ...

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Medical Super Groups: the Answer to Value-Based Reimbursement Success?

David MoyeJanuary 31, 2019

Moving toward a value-based methodology has proven to be burdensome for independent medical practices. With the shift, practices tend to face small group discrimination, escalating administrative loads and costly technology requirements.

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5 Ways Physician Practices Can Adapt to High-Deductible Plans

Norm SchoonoverJanuary 4, 2019

The secret is out; high deductible plans are everywhere and are proliferating the market. High deductible plans are not new and they have been around for over a decade. However, as the cost of health care continues to rise at a rapid rate and more employers are looking to help offset the cost of providing health care to employees by turning to ...

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What is Revenue Cycle Management in Healthcare?

R1 RCMAugust 10, 2017

The healthcare industry in the U.S. is undergoing a significant transformation due to a transitioning coding system amidst changing regulations regarding value-based care and increasing pressures on healthcare providers to improve patient care while simultaneously lowering costs. In light of these transformations, regardless of whether you are ...

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The Importance of Understanding Your Practice’s Payer Mix

R1 RCMOctober 20, 2016

Do you know what percentage of your practice’s patients are self-pay? How many of your patients have private insurance? And of those who have private insurance, do you know what percentage of that group has a high-deductible plan? If you know who your largest payers are, are you in tune with news about their coverage and reimbursement ...

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