Healthcare Revenue Cycle

Articles focused on patient access, billing, coding, claims management, collections, denials prevention, and revenue cycle optimization.

Vanderbilt Health harnesses data to improve revenue cycle management

Close to half of healthcare finance professionals say in a survey that their organizations are experiencing a severe shortage of revenue cycle management (RCM) talent — and many are exploring automation as a way to keep RCM operations working properly. It’s a move that Vanderbilt Health in Nashville, Tennessee, made just prior to the pandemic — and…

By Jeni Williams December 13, 2022

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…

By Nick Hut December 9, 2022

How healthcare organizations can defend against financial hazards in 2023

What are the most critical strategies to steer healthcare organizations in the direction of financial stability in the following year and beyond? A couple tips include reducing bad debt and accessing external benchmarks for supply pricing.

By HFMA December 6, 2022

HHS says the co-provider requirement for good-faith estimates is being tabled indefinitely

The U.S. Department of Health and Human Services has given hospitals and other healthcare providers a break on enforcement of a looming requirement for co-providers to be included on good-faith estimates (GFEs) furnished to uninsured patients.  HHS announced in an updated FAQ that it will continue to exercise “enforcement discretion” instead of potentially penalizing providers starting Jan.…

By Nick Hut December 5, 2022

Utilization Review: 5 Reasons Hospitals Lose Revenue

An effective utilization review program must revolve around the right management and processes as well as communication among teams.

By Lisa Bragg and Amanda (Fishman) Koroly December 5, 2022

Healthcare News of Note: Trust in local healthcare systems’ handling of the pandemic increased during a 28-month time span

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Trust increased in healthcare providers’ handling of the pandemic when compared with the government, working-age adults suffer financial setbacks after admission for traumatic injury, and deaths by stimulants have increased.

By Deborah Filipek December 2, 2022

Conserving capital expenses through clinical asset reallocation

Michelle Brandt is vice president of physician, ambulatory contracting & credentialing at MedStar Health in Columbia, Maryland About TRIMEDX As an industry-leading, independent clinical asset management company, TRIMEDX helps healthcare providers transform their clinical assets into strategic tools, driving reductions in operational expenses, optimizing clinical asset capital spend, maximizing resources for patient care, and delivering improved safety & protection. This published piece is provided solely for informational purposes. HFMA does not endorse the published material or warrant or guarantee its accuracy. The statements and opinions by participants are those of the participants and not those of HFMA. References to commercial manufacturers, vendors, products, or services that may appear do not constitute endorsements by HFMA.

By HFMA December 1, 2022

CareCredit healthcare credit card provides flexible payment options for both patients and healthcare providers

Read about one company's payment solution that gives patients a way to pay for out-of-pocket healthcare costs while enabling health care organizations to receive payment for services within two business days.

By HFMA December 1, 2022

Revenue Cycle Insights newsletter: Medicare outpatient payment bump less than first appears

On the surface, CMS is granting Medicare outpatient care a 3.8% payment increase, but a variety of negative adjustments that will vary by provider are going to cut into the net gain. Senior Editor Nick Hut breaks it all down. Also, Vanderbilt Health is reaping gains from its earlier adoption of automation technology in revenue…

By Paul Barr, CRCR, MS, MBA November 18, 2022

David Johnson: Rewiring healthcare’s smartest professionals (Hint: It’s not physicians)

I won’t keep you in suspense. Healthcare’s smartest professionals are the tens of thousands of individuals who populate its revenue cycle operations. Revenue cycle professionals determine how much payers fork out and how much providers receive for healthcare treatments. They constitute the beating heart of the nation’s transactional healthcare system. Their ingenuity knows no bounds.…

By David W. Johnson November 1, 2022
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