Why Health Plans Are Easing Preauthorization
In an attempt to build cooperative working relationships with physicians, some health plans are trying to reduce the burden of preauthorization.
Avoiding the Costliest Denials
Eligibility, outpatient medical necessity, and case management authorization continue to be three of the costliest denials. To avoid the negative effects of these types of denials, it is critical to implement an improvement process based on data.
Ask the Experts: Self-Pay Accounts
Has anyone placed self-pay unpaid accounts with a third-party agency at day 90? If so, was it beneficial or detrimental?
Electronic Claim Processing Can Save Millions of Work Hours
If providers fully adopt automated processes for claim transactions, a minimum of 1.1 million hours of administrative work could be saved per business week each year, according to a 2016 CAQH study.
Finding Common Ground on Physician Documentation
Revenue cycle teams looking to improve physician compliance with documentation requirements should identify how better documentation supports physician priorities.
Tackling Preservice Pricing Plans
Despite evidence that patient demand for preservice pricing is growing, only 30 percent of patients are being offered pre-treatment cost estimates.
Revenue Cycle Department Gives Beyond Its Patient Access Services
MetroHealth’s revenue cycle staff work together to assist the local community with basic needs as well as healthcare access and financing.
New CMS Guidelines Impact Coder Roles
How is the role of coders in the clinical validation process changing?
Solving the Unique Revenue Cycle Challenges of EMS Providers
An EMS provider cut A/R days in half by addressing the unique challenges of emergency medical service revenue cycle processes―limited time to capture patient data and insurance coverage information and a lack of technology integration with other healthcare providers.
Working with Physicians to Improve Documentation
Getting high-quality documentation requires understanding physicians’ priorities, their thinking styles, and the time pressures they work under. Demonstrating how documentation can improve patient care is key to motivating physicians.