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Accelerate your own or your team's revenue cycle expertise with our Certified Revenue Cycle Representative program.
This Dec. 10 webinar explains how Billings Clinic bridged gaps between pharmacy expense data and financial system to ensure proper pricing and billing.
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MAP App is a web-based application that helps organizations improve revenue cycle performance based on industry-standard metrics called MAP Keys.
Find suppliers and products in this comprehensive vendor directory for healthcare finance professionals.
Improve your revenue cycle performance through standard metrics, peer comparison, and successful practices.
Financial, clinical, and administrative leaders identify key strategies to drive healthcare value.
Help patients understand the cost of services they receive, their insurance coverage, and
their individual responsibility.
Peforming self-audits of claims and implementing the OIG's voluntary compliance program can help providers avoid audits by the government and other payers.
Providers that would like to respond to complex RAC reviews electronically should consider three strategies.
Medicare-severity DRGs, implemented in 2007, are now an integral part of the overall value-based purchasing initiative.
Hospital management's objective is to provide a charge capture system that maximizes revenue through a systematic charge capture process.
View the document
Do you have the right toolbox for your organization?
Use these comprehensive checklists during your internal audit process to demonstrate your entity's compliance with the OIG's compliance guidelines and to ensure your compliance bases are covered.
With labor at a premium, how does one manage increasing volume without adding staff?
To assess the risk posed by improper billing, coding, and pricing for pharmacy items, hospital finance leaders should perform an audit of the pharmacy department's charge description master.
Over the past nine months, I've read headline after headline on the front pages of major newspapers questioning the performance, pricing policies, and even the purpose of not for profit healthcare organizations.
The IRS issued proposed rules in April regarding community health needs assessments and other requirements that section 501(c)(3) hospitals must meet to maintain tax-exempt status.
Hospitals can improve their revenue capture by implementing an automated internal audit function that identifies the root causes of denials, thereby helping to prevent the denials from occurring in the first place.
A case study of a fictional hospital illustrates that even modest changes in contract terms from payers can produce large swings in revenue yield, emphasizing the importance of testing proposed contract modifications before entering any agreement.
Use of an external auditing firm allows hospitals and health systems to gain an objective review of their accounts payable systems without interrupting their staff’s day-to-day workload. Some firms conduct a more in-depth analysis of the supply chain, looking for root causes and making recommendations for change. Consider the following questions to select an external auditor that best meets hospital or health system needs.
Audits often reveal overpayments and unredeemed credits for purchased goods and services that can add up to millions of dollars in large, complex health systems.
A job description for a Corporate Compliance Specialist which could double for a Revenue Integrity position. This document posted courtesy of Christine Fontaine.Download Job Description
When the number of missing charges skyrocketed with the implementation of a new OR health information system, department managers at NYU Hospital for Joint Diseases created a more systematic approach to charge capture.
Oftentimes, non-core businesses wind up being managed using incomplete operating statements with little focus on metrics.
Knowing the full range of key topics that should be discussed with an actuary can help guarantee recognition of an organization's insurance program and better manage its liability.
Learn how CoxHealth consolidated and standardized its billing auditing across the organization, which resulted in the health system to more efficiently address external audits.
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