Common coding challenges hospitals face and how to fix them
Managing revenue and profitability has become increasingly difficult for hospitals, leading many to take drastic cost-cutting measures. However, there are less painful options, including reevaluating and revamping medical coding processes. Managing revenue and profitability has become increasingly difficult for hospitals, leading many to take drastic cost-cutting measures. However, there are less painful options, including reevaluating…
How leveraging artificial intelligence in utilization management can enhance your revenue cycle
This white paper dives into how AI will help make healthcare sustainable and provide more of a focus on patient care. The goal is to decrease industry challenges and create new efforts to reduce the administrative cost of healthcare.
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…
Denials Management Research Report
HFMA, with sponsorship from Waystar, surveyed 415 healthcare finance and revenue cycle executives to understand how denials are affecting their revenue cycle operations.
Survey reveals 5 opportunities to tackle denial prevention and management
In this survey, responses found when organizations devote greater resources to denial management than to denial prevention, their rate of first-pass denials is higher: 13.6% versus 10.9%.
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…
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.
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…