Is It Time for a Billing Operations Check-Up? How to Assess the Health of Your Revenue Cycle

Posted in Accounts Receivable (A/R), Offshore Medical Billing, Outsourced Medical Billing, RCM Solutions

Balancing the competitive landscape that comes with physician practice consolidation combined with population health and the shift to value-based care is a lot to consider for busy hospital physician practices. Add in the constant changes in regulatory guidelines, enhancing the patient experience and most importantly – a continued focus on quality and safety and most hospital administrators have little resources left to focus on improving the revenue cycle.

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3 Ways Hospitals Can Improve Their CMS Star Rating (Regardless of its Flaws)

Posted in RCM Solutions

Lots of questions and headlines began swirling earlier this month after the Centers for Medicare and Medicaid Services (CMS) released its hospital star ratings – a “seemingly” simple system designed to help consumers make informed decisions about hospitals and the care they deliver. While consumers are used to 5-star ratings for hotels and restaurants, the healthcare industry is clearly far more complex. As such, a cloud of mystery and skepticism surrounds this incredibly powerful rating system – especially for the thousands of hospitals who participate in Medicare and are therefore automatically subject to stardom whether they like it or not.

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CMS Will Only Adjust Medicaid Rules – Not Drastically Change Them

Posted in RCM Solutions, Revenue Cycle Solutions

After much ballyhoo and for years of promising a major overhaul to the cost-prohibitive Obama-era managed care rules, the CMS has issued a proposed regulation that makes smaller changes – not the drastic “gutting” that had been promised — to the standards states meet when running their Medicaid plans.

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Billions of Dollars Flow into Private Medicaid Plans with NO Cost Oversight or Efficacy of Treatment Determined

Posted in RCM Solutions, Revenue Cycle Solutions

Cost containment has become a leading factor in the delivery of healthcare. What are some of the issues that are contributing to these burgeoning costs? One of them is Medicaid. We spent over $576 billion on Medicaid programs in 2017, as reported by the Kaiser Family Foundation.

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Outsourcing as a Solution for Revenue Cycle Management (RCM) Continues to Grow at a Rapid Pace

Posted in Business Process Outsourcing (BPO), Coding Outsourcing, Offshore Medical Billing, Offshore Medical Coding, Offshore Revenue Cycle Management, Outsource Coding, Outsourced Coding, Outsourced Medical Coding, RCM Solutions, Revenue Cycle Management (RCM)

Facing lower reimbursements and shrinking margins, hospitals are exploring ways to capture more revenue. This has led an increasing number of hospitals across the nation to outsource their Revenue Cycle Management to professional outsourcing companies. This trend was identified in a recent Black Book™ survey, which included responses from 1,309 hospital CFOs and business office …

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Be Prepared for “Surprise” Medical Billing

Posted in Medical Billing BPO, Offshore Medical Billing, Outsourced Medical Billing, Patient Access Management, RCM Solutions, Revenue Cycle Management (RCM)

A recent article on the Radiology Business Management Association (RBMA) web site discussed consumer’s frustration with the cost of medical care as being at an all-time high as many purchasers of narrow-network, high-deductible and high-co-pay health plans are finding out that the benefits they get from their monthly insurance premiums are much more limited than …

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High Deductible Self-Pay Accounts Can Be a Major Threat to Revenue Cycle Management

Posted in Patient Access Management, RCM Solutions, Revenue Cycle Management (RCM)

According to data from the latest quarterly Crowe RCA Benchmarking Analysis: “Patient Financial Responsibility on the Rise,” healthcare providers could be facing a major threat to their revenue cycles. The analysis found that in the past year, insured patient financial responsibility has grown from 23.3 percent to 26.9 percent for outpatients and 10.2 percent to …

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What Will Be the Effects of Merger Mania on the Delivery of Healthcare?

Posted in Best Practices, RCM Solutions, Revenue Cycle Solutions

By Nitin Thakor, GeBBS President & CEO A Healthcare Finance News article last year quoted a New Jersey hospital executive as saying: “Big is going to be better; small is not going to survive.” Time will tell if he is right, but most industry analysts agree that the coming year will be full of acquisitions …

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Specificity of ICD-10 Coding Can Improve Reimbursements for Vaccine Administration

Posted in ICD-10, Medical Coding, Medical Coding BPO, Outsourced Coding, Outsourced Medical Coding, RCM Solutions, Revenue Cycle Management (RCM)

Administration of vaccines is an important part of healthcare delivery, and a critical contribution to preventive public healthcare. However, risings costs are making it difficult to align vaccine administration expenses with revenues. There may be some relief to these rising costs and it comes from something that was once seen as a burden for medical …

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