Healthcare Revenue Cycle

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

How to empower revenue cycle employees to solve problems: a case study of Mass General Brigham 

In traditional revenue cycle structures, managers move up the hierarchy because they are good at getting work done and solving problems. However, a successful continuous improvement culture needs not only effective managers but also empowered front-line staff who can share their insights and expertise. With this premise in mind, leaders at Mass General Brigham (MGB)…

By Katy Courson, MPH June 17, 2025

Insurers, patients pay less of their bills

Healthcare providers faced growing challenges last year in getting paid for care among patients covered by insurance, according to new benchmark data from Kodiak Solutions. And it was both insurers and patients who were lagging in payment or not paying at all. Denials of coverage by health plans, already a problem in 2023, increased during…

By Paul Barr, CRCR, MS, MBA June 5, 2025

5 key strategies for a successful mid-cycle

Today’s mid-cycle teams face mounting pressure. Oversight is tightening, payer policies are shifting rapidly and margins continue to shrink. This phase is no longer a simple pass-through, it’s a vital operational checkpoint that demands both strategic leadership and attention to detail. Hospitals that implement structure and prioritize accuracy tend to stay ahead. Those that don’t…

By HFMA June 2, 2025

Vendor and staffing management, plus the latest in budget reconciliation

Danelle Newman from OSS Health discusses how to strike a balance in vendor and staffing management. Also in this episode, HFMA Senior Editor Rich Daly talks with HFMA Policy Director Shawn Stack about the House-passed reconciliation package.

By Erika Grotto June 2, 2025

How Revco Solutions maximizes cash recoveries and improves the patient financial experience

Learn how one company optimizes revenue recovery through proactive denial prevention, clean claims strategies and intelligent automation — ensuring faster, more accurate reimbursement.

By HFMA May 30, 2025

How to strengthen eligibility determination with a proactive approach

How can healthcare revenue cycle teams strengthen engagement around eligibility determination and improve patient satisfaction, operational efficiency and their bottom line? Discover solutions to these challenges in this white paper.

By HFMA May 30, 2025

Fortifying revenue management: The critical role of health information management in cybersecurity preparedness

A hospital’s health information management (HIM) team oversees the flow of patient care documentation in healthcare organizations, supporting accuracy, accessibility and security. In the revenue cycle, HIM maintains financial integrity by managing patient data, ensuring proper coding and documentation for billing and verifying clinical data for compliance and reimbursement. HIM also plays an active role…

By HFMA May 7, 2025

CFPB no longer supports the final rule on medical debt reporting

The Consumer Financial Protection Bureau (CFPB) has formally withdrawn its support for a Biden administration rule that would keep medical debt from appearing on consumer credit reports. The rule has been staunchly opposed by the credit-reporting and debt collector industries and also has generated concern among provider advocates who think it could remove an incentive…

By Nick Hut May 6, 2025

How to develop a playbook to provide patients with timely access to care

If you reviewed the new Vizient/Kaufman Hall 2025 Trends Report, Strategy is (finally) back in the driver’s seat, you might have noticed one startling data point: A 1% increase in “loyal” patients (that is, patients who spend at least three quarters of their healthcare dollars within one health system) can yield a $40 million revenue…

By Bonnie Proulx, DNP, APRN, PNP-BC, FAAN April 25, 2025

The IPPS proposed rule, and tackling charge capture issues

Nick Hut and Shawn Stack discuss the proposed rule for the Inpatient Prospective Payment System. Later, Taylor Searfoss, a vice president at Ni2, an Infinx company, discusses challenges in charge capture.

By Erika Grotto April 21, 2025
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