3 key interventions to address lagging payer reimbursements
It seems as if commercial payers are doing all they can to keep from reimbursing providers in a timely manner. According to a recent report by Crowe, 31% of claims submitted to commercial payers in the first quarter of 2023 were not paid for at least three months, as compared with 12% of Medicare claims.…
Is This the Age of the Payvider?
By now, most health systems are familiar with the term payvider, and many are weighing the pros and cons of initiating their own payvider solution. The critical tipping point to act may well be here today, as health systems feel increased pressure to make greater financial and strategic impact for their organizations even as conditions…
Driving dollars through data: An innovative way to improve self-debt collections
Recent industry trends indicate the challenge of self-pay collections within the revenue cycle management (RCM) space will continue to rise, driven primarily by the increasing number of consumers opting for high deductible health plans. Effective collections strategies require additional expertise to focus efforts where there is a higher return on investment. It’s time-consuming to chase…
The 5 provider strategies to improve profit margins
Improving financial performance and operating margins has become one of the most pressing concerns for health system CEOs. To meet future margin targets, leaders will have to bring a new level of focus, resources and structure to achieve deeper cost reductions on a recurring basis. At the same time, this is critical to ensuring that…
How predictive analytics and AI shed light on payer behavior
Providers and payers have become more collaborative as payment models evolve toward value. Still, payer-provider relationships can seem one-sided — decidedly in favor of the payer — as hospitals continue to face declining reimbursement and rising costs. The increase in denials is a great example, with rates skyrocketing by 20% over 5 years, according to…
Research summary: Study identifies health systems’ two biggest concerns — staffing and financial performance
HFMA, with sponsorship by Lifepoint, surveyed 100 healthcare respondents to better understand health systems’ concerns, including strategic priorities, staffing issues, improving the patient experience, partnerships, market expansion opportunities and co-location. Staffing and financial performance were the two greatest concerns for nearly all health systems. To learn more, download the key findings from the survey.
Stemming the outpatient profit squeeze with a revenue cycle workflow gap analysis
Hospital and health system outpatient, outreach and ancillary services are often confined to EHR systems to manage their billing. Designed for bigger-ticket, lower-volume claims, these systems lack specific front-end intelligence, system connectivity, and automation necessary to efficiently manage these departments’ unique billing need. Too often, the result is an unnecessarily high number of submission errors,…
Patient access: The key to a healthy revenue cycle
As hospitals and physician groups face ongoing labor shortages and skyrocketing costs, maintaining effective Patient Access processes is critical. Ensuring efficiency and accuracy upstream helps prevent delayed reimbursement downstream—while supporting a positive patient experience. Download this whitepaper to explore the three patient access processes that can help protect revenue and improve the patient experience. Identify…
5 ways end-to-end RCM improves the employee experience
In today’s healthcare landscape, it can be very difficult to find and retain top talent. The key? Improve the employee experience. See the 5 ways end-to-end RCM can enhance your team’s day-to-day, creating a superior work environment that speaks for itself. Inside this guide, you’ll learn how to improve the employee experience by enabling more…
4 opportunities to improve mid-cycle revenue operations
The quality of a hospital’s revenue cycle processes directly impacts the health of its bottom line. In an age of stagnant margins, hospitals should do all they can to improve revenue cycle efficiency. The mid-cycle—that critical phase between patient registration and claims submission — is a great place to start. Numerous challenges arise during this…