Healthcare Revenue Cycle Management

Revenue cycle analytics and how providers can help create best practices for the industry

Erin Weber of CAQH discusses how providers can participate in the work of setting best practice guidelines, and Lori Zindl of OS Inc. and Rachel Dallman of Phelps Memorial Health Center talk about opportunities to learn from analytics.

By Erika Grotto August 12, 2024

Report: Payer requests for information are slowing reimbursement

Payers are increasingly rejecting claims through requests for information (RFI) that in total serve no purpose other than to delay reimbursement, according to “Death by a thousand requests,” a report from consulting firm Kodiak Solutions. RFI claim denial rates as a percentage of total billed charges climbed to 3.82% in 2024 through May, up from…

By Paul Barr, MS, MBA, CRCR August 8, 2024

Navigating the rising tide of denials

Managing the healthcare revenue cycle is more challenging — and more critical — than ever. Amid sluggish margins, ongoing staffing challenges and rising costs, providers feel unprecedented pressure to optimize their revenue cycles. Addressing the ever-increasing issue of denials is a great place to begin. The latest data on denials and proven strategies to reduce…

By HFMA August 7, 2024

Premier’s AI platform offers a data-driven solution for medical group leaders

Learn about how Provider Practice Benchmarking allows medical group leaders to directly measure their performance across more than 150 physician and advanced practitioner specialties in a number of areas from a single reporting platform.

By HFMA August 1, 2024

Ramifications of a proposed rule to halt credit reporting of medical debt

A proposed rule from the Consumer Financial Protection Bureau (CFPB) would curtail the inclusion of medical debt in credit evaluations, potentially shaking up healthcare billing and collections processes. The CFPB framed part of its rationale for the June 11 rule in the context of privacy, noting Congress previously limited the sharing of a patient’s medical…

By Nick Hut August 1, 2024

As providers seek resolution of continuing Change Healthcare issues, UnitedHealth Group reports strong financials

The aftermath of the Change Healthcare cyberattack affected the second-quarter financials of parent company UnitedHealth Group (UHG), but not to the point of hindering the company’s continued “diversified and durable growth,” CEO Andrew Witty said during a recent investor call. Q2 revenues increased by 6% year-over-year, while profits dropped by 5.5% amid costs stemming from…

By Nick Hut July 26, 2024

How healthcare providers can streamline A/R through partnerships  

The efficient management of accounts receivable (A/R) is essential for maintaining the fiscal health and operational effectiveness of any healthcare organization. Finance leaders are increasingly recognizing the benefits of leveraging strategic A/R partnerships to improve revenue cycle operations, decrease costs and boost liquidity. It is imperative, however, that they take a systematic approach to understand…

By Ryan Downs, CHFP, CRCR, CPA July 26, 2024

CMS looks to fortify primary care with proposed new codes for advanced care management

With newly proposed regulations, CMS aims to establish coding and payment for services that promote longitudinal relationships between clinicians and patients in primary care. The provisions, part of Medicare’s 2025 proposed rule for physician payments, incorporate new HCPCS G-codes for advanced primary care management (APCM). Three bundles of APCM services would be billable as codes…

By Nick Hut July 24, 2024

Healthcare Blame Game, Live from Las Vegas!

Deepak Manmohan Goyal, MD, MBBS, MBA, joins Brad and Erika at HFMA Annual on June 27, 2024, to discuss his work as executive director for revenue cycle and supply chain at Monument Health in Rapid City, S.D. and the financial assistance program that has increased the system’s charity care by $7.8 million in its first year.

By Erika Grotto July 22, 2024

The surest bets from HFMA’s Annual Conference in Las Vegas

Laxmi Patel from Savista discusses the potential for AI, and Kevin Hidenfelter from Millenia shares insights about generational payment preferences in interviews conducted live at HFMA's Annual Conference in Las Vegas.

By Erika Grotto July 22, 2024
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