New federal rule aims to eventually ease prior authorization processes
CMS is seeking to improve the prior authorization process in government programs such as Medicare Advantage (MA) and Medicaid, although the core provisions would not begin until 2026. The agency this week updated a Trump administration proposed rule with new proposals to “improve patient and provider access to health information and streamline processes related to prior authorization…
Cloudmed, an R1 company, helps health systems get paid for the care they provide
Using one company’s AI platform, health systems will find uncovered funds that can be used to hire essential practitioners, build new facilities and fund outreach programs.
Optimize the cost effectiveness of health through prioritizing the patient experience
Read up on various strategies from several health system executives, including taking full advantage of EHR, reducing expenses, improving patient experience and so forth.
Revenue cycle technology budgets rise to meet need for automation, AI and robotics, says new survey
See five areas where there is room for additional automation according to respondents in a recent survey. Also read about using AI in the revenue cycle and the benefits it brings hospitals and healthcare systems such as dealing with staffing challenges, dwindling margins and increased denial rates.
Most healthcare organizations want to augment current EHR workflows and would consider flexible outsourcing contracts
This pulse survey shows that there is no one-size-fits-all solution for managing today’s revenue cycle challenges. Savvy healthcare organizations know they need a combination of actionable insights and high-performance work teams to be successful.
Clinical audits and denials impact 3% or more of NPR being held in reserve
This pulse survey shows how healthcare organizations are currently tracking health system’s audits and denials from government and commercial payers.
Clinical Audits and Denials Research Report
HFMA, with sponsorship by MRO, surveyed 317 healthcare revenue cycle, finance and accounting executives to understand how organizations are handling claim audits, risk exposure, claim tracking, and reserves.
Revenue Cycle Operations Research Summary Report
HFMA, with sponsorship by Currance, surveyed 110 healthcare CFOs and revenue cycle, finance and accounting executives to understand how satisfied healthcare providers are with their current revenue cycle operations, and what they find most valuable.
Revenue cycle staff shortages push leaders to adapt quickly
The pandemic-driven workforce shortage is leading to significant changes in revenue cycle management operations at many hospitals and health systems.
Revecore helps hospitals increase revenue with technology-driven underpayment review and recovery solutions
Read about one company's singular focus with its underpayment review and recovery solutions is to stop the leakage and increase revenue. The company’s solution is built on unique, customized technology to collect dollars that would have otherwise gone unrecovered.