Results for Revenue Cycle Management (RCM)

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Results 1-93 of 93
  • Blogs

How RCM Technology is Transforming Denial Management for FQHCs and Tribal Health Centers

Claim denials are among the most persistent challenges in healthcare revenue cycle management (RCM). For Federally Qualified Health Centers (FQHCs) and Tribal Health Centers, denials create more than just administrative headaches—they can directly impact already limited budgets and the ability to serve vulnerable populations. Industry data from a 2024 Experian report shows denial rates across ...Read More
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  • Blogs

The Cost of Staffing Shortages in Revenue Cycle Management

Revenue Cycle Management (RCM) is the backbone of healthcare finance. It covers the journey from patient registration and insurance verification to medical coding, claims submission, and collections. When it runs smoothly, providers are paid promptly and can reinvest in patient care. However, the financial and operational consequences can be severe ...Read More
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  • Blogs

Optimizing RCM for FQHCs: A Modern Blueprint for Financial Success

Federally Qualified Health Centers (FQHCs) are on the front lines of ensuring accessible care and serving patients regardless of insurance or income status. However, balancing mission goals with tight margins consistently is challenging. Complex reimbursement frameworks (including PPS payments, sliding-fee scales, and multi-payer billing) mean that optimized revenue cycle management ...Read More
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  • Blogs

Strategic Denial Management: Protecting Healthcare Revenue in 2025

The Rising Challenge of Claims Denials Healthcare providers across the United States are confronting an alarming surge in claim denials that threatens financial stability and operational efficiency. Recent industry data reveals that approximately 11.8% of all medical claims were initially denied in 2024, a significant increase from 10.2% in 2020. ...Read More
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  • Blogs

How Offshore RCM Slashes Your Costs Without Compromising Quality

What if you didn’t have to choose between saving money and getting great results? It’s the question no one dares to ask—because for most healthcare finance leaders, the trade-off feels inevitable. You tighten the budget, quality dips. You invest in quality, costs balloon. Maybe you’ve been burned before. Maybe that ...Read More
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  • Blogs

Improving the Healthcare Revenue Cycle: Strategies, Benefits, and Emerging Trends

Efficient Revenue Cycle Management (RCM) directly impacts the financial health of healthcare organizations. Key strategies include enhancing patient access, ensuring medical coding accuracy, streamlining denial management, leveraging AI automation, and forming strategic partnerships. Optimizing RCM improves cash flow, reduces denials, enhances compliance, and boosts patient satisfaction, positioning healthcare organizations for ...Read More
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  • Blogs

What is Healthcare Revenue Cycle Management (RCM)

Healthcare Revenue Cycle Management (Healthcare RCM) is the backbone of every successful healthcare organization. It encompasses the entire financial process of patient care—from appointment scheduling and registration to the final payment of a balance. By optimizing RCM, providers can improve cash flow, reduce overhead costs, and focus on delivering quality ...Read More
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  • Blogs

How to Navigate the Complex Landscape of Healthcare Revenue Cycle Management

Healthcare providers are grappling with increasing challenges in managing their revenue cycles. The intricate interplay of patient demographics, evolving insurance regulations, the rise in chronic and severe medical issues, and rapid technological advancements has created a complex landscape that demands strategic and efficient solutions. This blog post will explore the ...Read More
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  • Blogs

Transforming Healthcare Revenue Cycle Management with RPA and Bots

Healthcare revenue cycle management (RCM) is seeing tremendous strides in operational efficiency and financial sustainability using AI technologies. Traditional RCM methods, prone to human errors, need help to keep pace with modern healthcare records and billing demands. Enter robotic process automation (RPA) and bots, which promise a streamlined, accurate, and ...Read More
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  • Blogs

Safeguarding Patient Privacy: How to Ensure HIPAA Compliance in Your RCM Processes

Protecting patient privacy is paramount in today's digital healthcare landscape. The Health Insurance Portability and Accountability Act (HIPAA) mandates strict guidelines for safeguarding patients' protected health information (PHI). Ensuring HIPAA compliance within revenue cycle management (RCM) processes is crucial for healthcare organizations to avoid hefty fines and reputational damage. Did ...Read More
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  • Blogs

Navigating the Fiscal Labyrinth: Cost-Containment Strategies for Healthcare RCM

The contemporary landscape of healthcare finance presents a formidable challenge for Chief Financial Officers (CFOs). Rising costs, shrinking margins, and an ever-evolving revenue cycle management (RCM) system create a complex labyrinth. Through strategic interventions and optimized Healthcare RCM processes, CFOs can mitigate financial pressures and unlock resources to enhance patient ...Read More
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  • Blogs

Optimizing RCM Healthcare Processes for FQHCs

Revenue Cycle Management (RCM) in healthcare is the financial process utilizing medical billing processes that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final balance payment.RCM unifies the business and clinical sides of healthcare by combining administrative data, such as a patient's name, ...Read More
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  • Blogs

The Suite Life: Benefits of an End-to-End RCM Solution

A well-structured revenue cycle is vital to a healthcare organization’s survival. An ineffective revenue cycle management (RCM) strategy will hinder a provider’s profitability and negatively impact the patient experience. These issues are compounded by the ever-shrinking margins with which healthcare providers must contend. Many healthcare organizations are ditching their disjointed ...Read More
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  • Blogs

Why RCM is NOT a Back-Office Function

As healthcare margins continue to shrink and payment reform continues at a snail’s pace, revenue cycle management teams may feel like the hospital’s entire future is dependent on their back-office efforts. Factors like increasing patient responsibility, a shift toward government managed care plans, the proliferation of narrow networks, and risk ...Read More
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  • Blogs

What’s Your 2020 RCM Strategy?

Heading into 2020, having a sound revenue cycle management strategy (RCM) in place is a top priority for hospitals and healthcare organizations trying to navigate the ever-increasing world of healthcare payment. Most healthcare leaders recognize that chasing reimbursement is getting harder than ever. High deductible health plans (HDHP) are increasing ...Read More
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  • Blogs

Five Ways to Think Differently About RCM

Improving your revenue cycle in an era of healthcare reform isn’t easy – but it’s the only way to survive as margins continue to shrink. Looking within your organization for ways to mitigate lost revenue and decrease leakage can lead to greater financial performance. Today’s savvy health systems are thinking ...Read More
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  • Blogs

Revenue Cycle Management- An Interdisciplinary Approach

In healthcare, providers at the bedside know the care team goes far beyond the nurse and doctor. Delivering the highest quality care requires an interdisciplinary model where experts are called on as needed, information is shared, collaboration and continuous performance improvement are part of the process. Much like a patient’s ...Read More
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  • Blogs

Rev Up Your Revenue Cycle with AI

With profit margins shrinking and the cost of health care going nowhere but up, operational leaders and consultants throughout the healthcare industry are looking in every nook and cranny to either find ways to cut costs or generate more revenue. With the ongoing need for costly equipment, an expert workforce ...Read More
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  • Blogs

The Age of Revenue Cycle Management Outsourcing Has Arrived

The RevCycle Intelligence e-newsletter reported recently that 80 percent of hospitals are vetting full revenue cycle management (RCM) outsourcing. The demand to outsource full RCM is up 86 percent from 2015 among hospitals and inpatient organizations. Approximately 80 percent of hospital leaders in a new Black Book survey of 709 ...Read More
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  • Blogs

Improve Your Revenue Cycle Management

The new value-based care reimbursement environment is changing healthcare revenue cycle management (RCM) and forcing healthcare providers to adopt new and unique RCM strategies. New value-based care models, whatever The Affordable Care Act (ACA) ends up being, and the transition to ICD-10 have added complex challenges to an already burdened ...Read More
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  • Blogs, Business Process Outsourcing (BPO)

Streamline Your Revenue Cycle Management

In their May 6, 2016 newsletter, the AMA stated that: “Patient care is the top priority and a source of passion for physicians, but making sure the business side of your practice is ‘healthy’ also can contribute to better outcomes and patient satisfaction.” We couldn’t agree more! This has been ...Read More
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  • Blogs, Business Process Outsourcing (BPO)

End-to-End Revenue Cycle Management Will Keep You Out of the News

A large Chicago-based health system recently posted an operating loss of about $186 million in 2015, nearly 15 times the amount reported in the previous year. In addition, the system will lay off 250 employees and leave 450 jobs unfilled. The health system has told its bondholders that it will ...Read More
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  • Blogs

Uninsured Rate Dips Below 10%

By Nitin Thakor, President & CEO I read with interest this week an article In Modern Healthcare’s e-newsletter titled, “Uninsured rate dips below 10%.” The statistic comes from The Centers for Disease Control and Prevention. In my opinion the most important sentence in the article follows: “The survey also found that 36% ...Read More
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  • Blogs

Why Are Doctors Leaving Private Practice?

According to a recent survey conducted by a major healthcare consulting firm, a growing number of U.S. doctors are leaving private practice for hospital employment. Only one-in-three will remain independent by the end of 2016, according to the survey. The number of independent physicians has declined over the last several ...Read More
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  • Blogs

Industry Mergers Will Necessitate Expert Revenue Cycle Management

The Aetna/Humana acquisition brings together Humana’s growing Medicare Advantage business with Aetna’s diversified portfolio and commercial capabilities - creating a company that serves the most seniors in the Medicare Advantage program and the second-largest managed care company in the United States. What is fueling this merger mania? It is rumored ...Read More
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  • Blogs

10 Best Practices for Credit Balance Resolution

Credit balances are simply a part of everyday life in the delivery of healthcare services. Unresolved credit balance accounts can distort the profitability of a healthcare facility and foster financial risks. Researching and correcting posting errors, duplicate payments, overpayments, and misapplied credits are not only time consuming, but also expensive. ...Read More
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  • Blogs

ERAs Are a Win-Win over Paper EOBs

The introduction several years ago of the ERA (Electronic Remittance Advice) created a quantum leap in the healthcare billing arena by providing an improvement to the traditional, paper-based EOBs. Astonishingly, many providers have not taken advantage of this revolutionary change. It has been estimated that even today only 46 percent ...Read More
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  • Blogs

Why Switch to ERAs?

Why Switch to ERAs? In addition to inefficient processing and high administrative costs, paper EOBs contribute to a provider’s struggle with physical storage and document inaccessibility. Rummaging through paper archives as a means to investigate and manage secondary claims does not promote efficiency. Even worse, your medical practice or hospital ...Read More
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  • Blogs

Why ERAs Are More Efficient than EOBs

It is no secret that the healthcare industry is burdened with costly administrative processes. A good example of this are paper explanation of benefits (EOB) forms that have been estimated to cost nearly $18,600 per physician per year in administrative fees. With the availability of tools like the electronic remittance advice ...Read More
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  • Blogs

Optimized Patient Access Management

Patient access management department structures vary among hospitals, but in best-performing facilities, patient access management functions are typically structured with their patient access staff members divided into three areas: pre-service, time of service and post-service to handle the issues unique to these processes at each stage in the continuum of ...Read More
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  • Blogs

Patient Access Management: The New Vanguard in Healthcare

With all of the changes in healthcare reimbursement policies and the influx of high-deductible patients, healthcare providers need to shift their patient access management strategies to meet these new challenges. No longer can the registration process be looked upon as a simplistic completing of forms and getting the patient into ...Read More
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  • Blogs

The Role of Predictive Analytics in Revenue Cycle Management

Healthcare billing service companies provide vital services to the medical industry; both hospitals and physician groups need their critical services. However, these billing service companies often experience their own operational pains in the form of ever-changing governmental regulations that make medical billing confusing and complicated. Other reimbursement mandates and collection ...Read More
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  • Blogs

The Unknown Unknowns: What you don’t know can hurt you!

This is a first in a series blogs that we believe presents an excellent strategic approach for achieving every healthcare provider’s end-goal during the transition to ICD-10 -- ensuring there is NO reduction or stoppage of their revenue stream. Our mission is to see a stronger U.S. healthcare delivery system come ...Read More
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  • Blogs

Preparation is STILL the key for ICD-10

There is an upside to this second delay for ICD-10; we should use this time wisely! There will now be NO excuse for not being prepared in October 2015. This additional window of time presents an opportunity for U.S. healthcare providers to spend this period preparing for the significant impact ...Read More
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  • Blogs

Strategies for Managing the Increased Self-pay Revenue Stream

In an earlier blog, we admonished healthcare providers not to let their revenue cycles be swamped by the rising number of new self-pay patients entering the healthcare delivery stream. Under the Affordable Care Act (ACA), the self-pay portion of a healthcare provider’s receivables is going to increase significantly. According to ...Read More
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  • Blogs

Hospital RCM May See More Bad Debt Due To ACA

Hospital Revenue Cycle Management is about to be challenged by an unintended consequence of the Affordable Care Act (ACA). Even as hospitals are set to see an influx of newly insured patients, industry watchers warn that bad debt may become an even larger problem under theACA, putting more pressure on ...Read More
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  • Blogs

Weak Revenue Cycle Management Can Spawn Many Problems

The effects of weak revenue cycle management can go well beyond just financial challenges. Revenue problems can also lead to patient dissatisfaction challenges, and this can lead to reimbursement problems. Why do so many hospitals experience problems with their revenue cycle? A good explanation is that busy healthcare providers are ...Read More
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  • Blogs

A Primer for Managing the ICD-10 Transition

The healthcare industry is justifiably apprehensive about the impending transition from ICD-9 to ICD-10. Between claim denials from incorrect coding and coders taking more time to deal with the new system, billing is more than likely to slow down considerably. However, The Centers for Medicare and Medicaid (CMS) officials are ...Read More
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  • Blogs

A Tool that Can Aid in Your ICD-10 Transition

Seldom has any mandate or compliance regulation had the potential to disrupt, so severely, the revenue stream of almost every healthcare provider. The transition to ICD-10 is going to require one of the most intense and longest learning curves in the history of U.S. healthcare. As everyone is aware, proper ...Read More
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  • Blogs

5 Practical Ideas to Aid in Your ICD-10 Transition

Everyone in healthcare, who deals with coding, is keenly aware of the October 2014 deadline that is looming over the industry. Some are facing it head-on; others seem to be ignoring it, hoping it will just go away. No matter where you stand on the timeline or on your journey ...Read More
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  • Blogs

How Can You Define Success with Your BPO Provider?

The first step in determining your success with a BPO provider is to define a clear set of objectives that you expect them to meet. If you can’t define what you expect them to do, you can’t measure it. When setting your expected objectives for your BPO engagement, make sure ...Read More
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  • Blogs

5 Key Strategies for Optimizing Revenue Cycle Performance

In today’s healthcare economic climate, the majority of healthcare providers are acutely interested in optimizing their revenue cycle performance. The first aspect to be considered is -- where is the best place to start? It is also important to remember that revenue cycle performance improvement is a journey, not a ...Read More
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  • Blogs

Top 5 Reasons Why ICD-10 Implementation Does Matter!

The October 1, 2014 ICD-10 implementation date is just around the corner. This will be one of the most comprehensive projects healthcare has ever faced with far-reaching impacts throughout our delivery system. Here are our Top 5 Reasons why ICD-10 does matter. 1.    ICD-10 will have a positive impact on ...Read More
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  • Blogs

GeBBS Healthcare Solutions to Showcase Coding Workflow & Automation Platform at RBMA 2013 Radiology Summit

NGLEWOOD CLIFFS, NJ, May 08, 2013 -- GeBBS Healthcare Solutions, Inc., an industry leader in healthcare revenue cycle management outsourcing solutions, will be demonstrating its state-of-the-art coding platform, iCode, at the Radiology Business Management Association (RBMA) 2013 Radiology Summit, May 19-22 in Colorado Springs, Colorado. iCode, a SaaS-based coding platform, ...Read More
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  • Blogs, Knowledge Process Outsourcing (KPO)

The Impact of Accountable Care on Your Revenue Cycle

Becoming an accountable care organization (ACO) requires that your facility adopt a completely new point of view when it comes to revenue cycle management. The goal of an ACO is to reduce costs by improving the quality of care provided to patients. Providers are encouraged to and boost preventative efforts ...Read More
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  • Blogs

Revenue Cycle Management (RCM) and Best Practices Adoption

For physicians, getting paid properly for the services they provide is extremely important. Between constantly changing coding rules and dozens of insurance contracts -- each with its own coverage, billing and payment terms -- many medical practices find it difficult to keep up. As a result, physicians too often are ...Read More
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  • Blogs

How To Heal Merger Maladies with Outsourcing | GeBBS

When you are one of the largest medical billing services companies in the Southwest U.S. and your mission is to help other physician groups solve their staffing and financial challenges, how do you react when you are faced with these very same issues? You take the advice of the old ...Read More
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  • Blogs

Keys To Revenue Cycle Management Success | Why Outsource?

Outsourcing Solution Saves Healthcare Provider from Smothering under Acquired Accounts Receivable (A/R) Avalanche   As an already large medical group with 4,200+ employed and contracted physicians, serving over 750,000 patients, what do you do, when overnight through an acquisition, you gain 100 more doctors and 80,000 additional covered lives? How ...Read More
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  • Blogs

How To Address Healthcare Revenue Billing Issues | GeBBS

Long Island Radiology Practice Utilizes GeBBS Healthcare Solutions to Address Billing Issues and Develop Enhanced Practice Billing Guidelines On January 20, 1953, Dwight D. Eisenhower succeeded Harry S. Truman as the 34th President of the United States. Later that year, Walt Disney’s feature film, “Peter Pan,” premiered, and the coronation ...Read More
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  • Blogs, HIPAA

Healthcare Solutions in India | The Globalization of Healthcare Delivery

Due to technology advances and process virtualization, the healthcare industry now has access to the highest-quality/lowest-cost services anywhere in the world, creating a unique opportunity to transform care delivery in the U.S. and around the world. Healthcare providers can now leverage global supply chains and operating systems for high quality ...Read More
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  • Blogs

How To Fix The Entire Revenue Cycle Management Process

There has always been an interest in Revenue Cycle Management (RCM) because healthcare organizations continually face delays in receiving payments that can often be measured in months. Uncertainty surrounds most of the healthcare payment process, and providers are looking to revenue cycle optimization as one way to regain control. Healthcare ...Read More
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  • Blogs

How To Reduce Costs & Improve Quality | Revenue Cycle Management

According to a recent healthcare technology research study, U.S. Revenue Cycle Management by HIMSS, focused on the revenue cycle management (RCM) marketplace, positive changes are predicted in the attitudes of CEOs, CFOs and IT directors toward the efficacy of RCM to improve a healthcare facility’s financial operation. The study included nearly ...Read More
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  • Blogs

Revenue Cycle Management (RCM) Assistance Comes in Many Forms

When it comes to revenue cycle management (RCM), you need an outsourced medical billing partner that understands all aspect and nuances of the billing process. Recently, a large radiology billing services company, located in the Northeast U.S., faced a unique billing challenge. The company had been in business for more ...Read More
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  • Blogs

Reward Yourself By Getting Legacy Accounts Receivable under Control

Today’s healthcare professionals, who are responsible for revenue cycle management, must feel like fire fighters who while fighting the main blaze must deal with smaller fires that keep breaking out all around them. The challenge these healthcare professionals face is how to ensure all present billing gets accomplished and collected, ...Read More
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  • Blogs

Top 5 Questions and Answers on Accountable Care

The federal government spends around $1 trillion a year on health care programs. Different communities — the elderly, the disabled, military and civilian federal employees, low-income individuals and their families, and others — benefit from these programs. The two largest programs are Medicare and Medicaid. Although nearly 48.6 million Americans ...Read More
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  • Blogs

5 New Ways To Solve Healthcare Revenue Cycle Management Problems

The healthcare revenue cycle management (RCM) is just beginning to feel the effects of consumerism as employers focus on containing healthcare costs. This means that today’s growing financial pressures on healthcare organizations will continue to escalate as consumers bear an increased financial responsibility for their healthcare costs. Hospitals are under ...Read More
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