HFMA/Change Healthcare: Pre-Authorization and Medical Necessity Opportunities
Change Healthcare and HFMA partnered on a research study that analyzed the state of claims denials in the United States. It focused on understanding providers' first-pass claim rates, denials occurring from lack of pre-authorization and medical necessity processes, and pain points that are opportunities for innovation.
Smartphone App Helps Users Identify Nearest EDs
Krislyn M. Boggs and Carlos A. Camargo, Jr. describe how the Massachusetts General Hospital-based Emergency Medicine Network helps people find the nearest emergency department.
Plateau Busting: Transforming a CDI Program to Optimize Quality and Revenue
United Health Services, a not-for-profit health system serving New York, realized substantial benefits by implementing a clinical documentation improvement program.
Financial Leaders Are Key Collaborators in Patient Access Restructuring
Finance leaders provide critical information and expertise in healthcare organizations that are looking to improve patient access.
Ask the Experts: Chargemaster Updates
Are members of the group assessing their chargemasters annually? What do they consider when deciding which charges to increase and by how much?
Ask the Experts: Stat Order Designation
I am seeking guidance on time frames that define stat orders, patient financial liability waivers for stat orders, and health system liability if patients wait to receive tests ordered as stat.
Partnering with Other Providers to Develop Community Needs Assessments
Four Milwaukee-area health systems are working together to complete federally mandated community needs assessments more efficiently. They partner with 18 local health departments to collect and analyze data that informs their local health improvement strategies.
Let Data Drive the Design
Healthcare providers can use methodical statement design approaches to successfully engage patients in the billing process.
Cone Health Overhauls Patient Engagement Strategy
New patient statements and a web portal helped Cone Health increase patient cash collection by nearly $13 million during a two-year period.
Revenue Cycle Risks and Rewards in the Era of Value-Based Care
Physician specialty practices face the daunting task of recalibrating their revenue cycle management processes to optimize their financial performance under value-based care.