Denials Management

Little progress seen in mitigating prior-authorization challenges

Prior-authorization challenges appear to be worsening for providers, despite a 2018 payer-provider effort to address such problems.

Rich Daly June 23, 2019

Handling patient financial conversations in high-stress ED scenarios

John DeZulovich, director of patient financial services, St. Clair Hospital, shares best practices for financial conversations in the emergency department. Plus, HFMA news and the "Fast Five" on avoiding emergency department denials.

Erika Grotto May 30, 2019

Utilization Review: 5 Reasons Hospitals Lose Revenue

Hospitals can gain significant revenue by implementing an effective utilization review program.

Lisa Bragg May 29, 2019

Practical tips for maintaining control over the revenue cycle

As evolving market trends shape healthcare payment, providers continue to face real-world, day-to-day challenges that contribute to unpaid claims, unnecessary denials, workflow inefficiencies, and rework. By implementing the recommendations outlined here, providers can obtain the necessary visibility and control over their claims payment processes that can help them not only sustain a healthy revenue cycle,…

Eric Arnson May 23, 2019

Boosting Accountability Helps ProMedica Save $108 Million in 2018

Each year, leaders at ProMedica set a 3 percent cost-reduction goal, which they believe is achievable and still has a significant impact on the bottom line.

Laura Ramos Hegwer May 19, 2019

Improving PHI Disclosure Efficiency in the Business Office

With pressure on providers to prove medical necessity and validate code assignments, business office staff must provide more patient information, such as medical records, putting greater demands on their time. Yale New Haven Health addressed this problem by implementing a centralized protected health information (PHI) disclosure management system.

Kim Charland, BA, RHIT, CCS May 14, 2019

Case Study: Hand & Wrist Center of Houston

The Hand & Wrist Center of Houston is a surgical practice that is using effectively using a combination of technology and service to significantly improve its revenue cycle.

Eric Arnson February 28, 2019

Practical Tips for Maintaining Control over the Revenue Cycle

Using technology to prevent denied claims and providing patients with price transparency are just two ways healthcare organizations can improve their revenue cycle performance.

Eric Arnson February 28, 2019

Bridging the Gap: The Role of the Physician Advisor in Revenue Cycle Operations

Hospitals are deploying physician advisors to bolster the revenue cycle in a variety of areas, including clinical documentation, denials prevention, utilization review, and value analysis.

Nick Hut February 4, 2019

Your To-Do List When Health Plan Contracts Change

Six steps can help revenue cycle leaders manage health plan changes effectively.

Lola Butcher December 3, 2018
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