Read more about the article Improving Revenue Cycle Management with Point of Service Collections via Estimation and Eligibility Checking

Improving Revenue Cycle Management with Point of Service Collections via Estimation and Eligibility Checking

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A significant share of today’s hospital and doctor reimbursements now come from patients rather than commercial payers, yet many providers haven’t updated their collection practices. As charge amounts on medical bills continue to rise, healthcare providers are increasingly challenged to collect the high deductible amounts owed them. Patients are also more conscious of how much they spend on healthcare services as medical costs consume an increasingly large portion of their paychecks.

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Read more about the article Expert Coding Can Ensure You Are Maximizing Your Revenue Cycle

Expert Coding Can Ensure You Are Maximizing Your Revenue Cycle

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Declining reimbursements are one of the biggest challenges healthcare providers face today. Ask any physician or hospital and they will tell you about the daily struggle of getting paid for their services. However, many healthcare providers are leaving a significant amount of money on the table by under coding.

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Read more about the article Pre-authorization as a Service Requires Both Technology and Human Components

Pre-authorization as a Service Requires Both Technology and Human Components

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Most claim denials are due to the lack of verifying benefit information prior to services being provided. Insurance verification process is crucial for all hospital encounters, whether inpatient, outpatient or ambulatory care. It will ensure that the hospital or physician receives payment for services rendered and will help determine the patient’s share of the charges referred to as the patient’s responsibility.

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Read more about the article Transforming the Business of Healthcare

Transforming the Business of Healthcare

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The overall theme of this year’s HFMA Annual Conference is “Transforming the Business of Healthcare,” and it is right on target. No other industry is experiencing more evolution and transformational change than healthcare. It seems that the only thing we can count on is change — this is even more true for the business side of healthcare delivery.

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Read more about the article The Importance of Eligibility Verification and Pre-authorization

The Importance of Eligibility Verification and Pre-authorization

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In medical billing terminology, eligibility verification, pre-authorization, prior authorization and pre-certification are terms that may be used interchangeably to mean that for certain situations and procedures, providers have to contact insurers in advance and obtain a certification number in order to be reimbursed properly (or at all) for services. Insurance verification and insurance authorization services play a vital role in revenue cycle management. In fact, most claim denials happen when a patient is ineligible for services billed by the provider.

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