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Artificial Intelligence for RCM: Separating Hype from Reality
A growing volume of tagged data is exacerbating an already complex healthcare revenue cycle management (RCM) process that is largely transactional in nature, thus making RCM an area that is prime for automation and the application of artificial intelligence (AI). From automating manual and redundant tasks within patient access, coding, billing, and collections to applying…
Ensuring Access to Medicaid Services Proposed Rule Summary
On May 3, 2023, CMS published in the Federal Register a proposed rule entitled “Medicaid Program; Ensuring Access to Medicaid Services” (88 FR 27960-28089). The rule proposes policies that take a comprehensive approach to improving access to care, quality and health outcomes, and better addressing health equity issues in the Medicaid program across fee-for-service, managed care delivery…
How healthcare organizations navigate claims processing
View the results of a survey about claims processing and revenue cycle performance conducted with more than 625 healthcare leaders.
Leveraging extensible technology to create consumer-centric healthcare ecosystems
Implementing new technologies can eliminate tedious tasks and open the door for more impactful work as well as provide patients with easier access to convenient scheduling, registration and billing options. Dive into this roundtable for additional insight on technologies progressing the industry.
Healthcare providers seeing more diagnosis-related group downgrades and ghost denials
Each year, tens of millions of medical claims will be denied by healthcare payers. One executive director led a session with more than a dozen attendees highlighting their experiences with DRG downgrades and lessons learned to help other organizations better measure, manage and successfully appeal these complex denials.
IMA and HFMA Release Report on Cost Management in Healthcare
As the complexities faced by one of the largest and most essential industries continue to rise, IMA® (Institute of Management Accountants) and the Healthcare Financial Management Association (HFMA), today released “Cost Management in Healthcare: Status Quo and Opportunities.” The joint report acknowledges the challenges, identifies opportunities, and presents actionable recommendations for accounting and finance leaders to help healthcare institutions improve quality while lowering costs.
Addressing the Rising Patient Payment Obligation: Impact and Strategies amid today’s challenging healthcare environment
In the Fall of 2021, CommerceHealthcare® sponsored a focused survey conducted by the Health Management Academy (HMA), an organization for executives from the nation’s top health systems and leading companies. The HMA survey involved both quantitative polling and in-depth telephone interviews to explore current issues in patient financial experience. This report combines those findings with…
Are you ready for the Medicaid ‘unwinding?’
The phase-out, or “unwinding,” of the three-year Medicaid continuous enrollment program began on April 1, and states have started to disenroll ineligible members. They have 12 months to complete the recertification process. The HHS estimates that around 8.2 million Medicaid enrollees, of which 4.7 million are adults ages 18 to 34, will lose Medicaid coverage, while 5.3…
Harris Affinity Decision Support can help healthcare leaders identify meaningful areas for improvement
Improve your healthcare organization by leveraging advanced cost, performance, reimbursement and profitability data to inform and drive critical financial, operational and clinical decision-making.
Creative solutions to tackling top challenges in healthcare: 3 key insights
In this roundtable, several healthcare leaders shared lessons they learned navigating through major challenges due to COVID-19 including data security concerns, high rates of burnout and workforce shortages.