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5 Steps to Increase Payer Collections

On 4th Apr 2019

Sooner or later, we have all heard the warning, “Don’t sign it until you’ve read it”. Wise though it may be, it can be difficult to abide by that sage advice, especially when signing 3rd party payer contracts. Despite knowing full well the importance of every word on every page, the sheer volume makes it daunting at best, impossible at worst. For facilities, those millions of contractual words hold the details for reimbursement.

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Integrating Healthcare Denials Management Technology for Flawless RCM

On 21st Feb 2019

The need for revenue cycle management technology has never been greater. As providers seek ways to survive under regulatory pressures like MACRA, daily CMS policy changes, and the switch to value based care, a rugged revenue cycle management system emerges as the best way to protect revenue. Without it, revenue will seep through holes caused by legacy billing processes and old systems. Knowing that technology is needed is Step One; knowing which technology to purchase is just as important.

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The Benefits of Having a Revenue Cycle Blueprint

On 5th Feb 2019

When your office space no longer fits the needs of your business you have two choices; renovate the floor plan or move. The same is true of your revenue cycle management (RCM) system. When it no longer fits the needs of your healthcare organization you have two choices; fix the one you have or buy a new one. Finding an RCM solution that delivers a blueprint for continual growth, rather than a static map for the status quo, is the answer.

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Operational efficiency in healthcare contract management

On 31st Oct 2018

Healthcare operational efficiency - payer contract management

Healthcare contract management isn’t just important to healthcare organizations - it’s essential to viability. It isn’t an option, it’s a core function to financial well-being. When operational efficiency in payer contract management is achieved, it can yield robust financial benefits, improve reimbursement and capture revenue before it is lost. Comprehensive management of payer contracts is the foundation on which strong financial performance is built.

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Underpayments and Invisible Denials - The Silent Revenue Killers

On 11th Oct 2018

The central question for most healthcare organizations and physician practices is how to protect revenue. A small decline in reimbursements can have wide ranging implications. However, the complexities of today’s reimbursement and the costs of revenue cycle management can make it prohibitive to control every single dollar-generating detail. Financial losses may be recognized, but identifying the reasons are another matter. Automated processes are the best way to protect revenue, identify and rectify the causes, and guarantee that a dollar earned is a dollar reimbursed.

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Reducing and Collecting on Healthcare Payer Denials and Underpayments

On 13th Aug 2018

Reducing and Collecting on Denials and Underpayments Through Healthcare Payer Contract Management

Of all the pressure points faced by healthcare organizations today, healthcare payer contract management remains at the top of the list. Healthcare denials management and underpayment management are the achilles heel of every revenue cycle management function. According to MGMA, it’s estimated that seven to 11 percent of all claims are underpaid, and that is just the tip of the iceberg.

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Accurate Revenue Forecasting in the Value-Based Care Era

On 18th Jun 2018

Almost one-third of all U.S. healthcare reimbursements are now tied to outcomes, with alternative payment model spending totaling $355 billion annually, according to a study by the Health Care Payment Learning and Action Network. By its own tally, the Centers for Medicare & Medicaid Services expects to set aside $1.9 billion for its Medicare value-based care incentive payments in 2018. 

Understanding value-based contracting