Support a successful healthcare revenue cycle with content on denials management, patient access and patient financial conversations.
Revenue Cycle
News
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Patient Financial Communications
A newly issued federal rule on surprise billing includes regulations designed to improve price transparency for self-pay patients.
By Nick Hut
Article
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Patient Access
One company uses its patient financing program to address patient access to care and the rising cost of healthcare, two of healthcare’s biggest challenges.
Blog
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Coding
The new set features more than 400 CPT code changes from 2021.
By Nick Hut
News
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Patient Access
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Expectations for convenient access to care in the pandemic era, a look at ICU bed use across the U.S., and the cost of hospitalizations among...
By Deborah Filipek
News
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Revenue Cycle
Three winners of HFMA’s 2021 MAP Award share their innovative and effective strategies to build a strong revenue cycle amid uncertainty.
By Laura Hegwer
Article
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Patient Access
As provider organizations develop sophisticated automated systems, they should also make sure patients always have an opportunity to talk with a real person in the organization, because patients tend to be drawn to organizations where they ...
By Day Egusquiza
How To
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Patient Financial Communications
Creating the ideal patient billing experience not only improves revenue cycle performance, but also boosts patient satisfaction and quality scores.
News
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Revenue Cycle
Presented this year as part of HFMA’s Annual Conference Virtual Preview, the MAP Awards honored organizations that used innovative and effective strategies to achieve excellence in revenue cycle performance in 2020-21.
By Nick Hut
Article
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Financial Counseling
Learn how one company specializes in helping healthcare organizations of all sizes diagnose the root cause of poor revenue cycle performance and then make improvements.
How To
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Revenue Cycle
Health systems can reduce denials by using claims management tools, but their use must be supported by a commitment to ongoing process improvement within the organization.
By Eric Matson
Article
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Bad Debt
One company addresses the challenges of complex rules regulating Medicare bad debt processes and reporting, which makes payment recovery for hospitals difficult.
News
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Charity Care
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles, including a reduction in charity care in 2020 due to fewer patients, a review of physician burnout and moral injury data, and what early adop...
By Deborah Filipek
Research & Reports
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Denials Management
This HFMA Claim Integrity Task Force report standardizes definitions and categories for claim denials, which creates a common language to use across healthcare providers and plans and is critical to payment collection improvement efforts.
Article
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Revenue Cycle
A new task force is looking to improve the data and KPIs needed to further reduce denials.
By Erika Grotto, CHFP, CRCR
Trend
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Denials Management
Revenue cycle leaders share their perspectives on managing denials during the COVID-10 pandemic, including the need to keep up with new codes and evolving payment guidelines.
By Jeni Williams
Research & Reports
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Self-Payment Collection
See the key takeaways from hospital and health systems’ leaders, who share their perspectives on COVID-19 and its effect on the revenue cycle during the HFMA Digital Annual Conference.
Executive Roundtable
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Patient Access
Learn key takeaways from 15 revenue cycle leaders who shared performance at the HFMA Digital Annual Conference lessons learned around ways to strengthen and sustain revenue cycle.
Case Study
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Patient Financial Communications
Four companies presented 10-minute case studies at the HFMA Digital Annual Conference. Leaders from these organizations share the solutions of the case studies, which drive improved solutions in healthcare revenue cycle.
News
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Denials Management
HFMA’s Claim Integrity Task Force, in collaboration with business partners, set out to scope and define metrics that could be adopted industrywide for benchmarking.
By Chuck Alsdurf
Article
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Revenue Cycle
An initiative that incorporates HFMA’s MAP Keys has significantly reduced vendor management costs, enhanced net revenue and strengthened efficiency and performance among 11 collaborating health systems.
By Jeni Williams
Article
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Patient Financial Communications
Discover how a provider of patient financing company uses a patient-focused approach to ensure each patient receives the same care with their financial obligations as they do with their clinical care.
News
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Patient Financial Communications
HFMA recently updated its industry guidelines on billing dispute resolution practices in response to the financial challenges of the pandemic and public pressure.
By Rich Daly, HFMA Senior Writer and Editor
Blog
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Self-Payment Collection
HFMA's Chad Mulvany says healthcare organizations should ensure their self-pay revenue cycle process follows best practices as it’s likely with more people uninsured there will be increased scrutiny of these processes.
By Chad Mulvany, FHFMA
Trendsetter
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Self-Payment Collection
A forward-thinking bank talks about its accessible patient finance program, which gives patients a way to afford care while ensuring timely payment for healthcare organizations.
Article
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Patient Access
A revenue cycle management company talks about the importance of experience, versatility, and customer service when responding to current and emerging revenue cycle challenges.
Case Study
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Revenue Cycle
Strong change management played a key role in an HFMA MAP Award winner’s revenue cycle transformation.
By Amy Assenmacher, CHFP, FHFMA, and Matthew Cox, CHFP, CPA
Case Study
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Revenue Cycle
Intervention efforts pre- and post-treatment engaged patients at Northwestern Medicine's cancer treatment facilities and helped reduce bad debt by 65% per month from the baseline period to the intervention period.
By Sheetal Kircher, MD
News
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Revenue Cycle
HFMA's Digital Revenue Cycle Conference features 20 presenters during live sessions, the ability to earn CPE credits and time for networking and peer-engagement.
By Deborah Filipek
News
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KPIs
During Day 4 of the Digital Annual Conference, HFMA recognized the 23 winners of the 2020 MAP Awards.
By Nick Hut
News
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Revenue Cycle
Responding to workplace challenges posed by the COVID-19, Spectrum Health in Grand Rapids, Mich., transformed its work-from-home policy approach into one that worked for all aspects of the revenue cycle — back, middle and front end — while ...
By Eric C. Reese, PhD
Article
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Revenue Cycle
HFMA's Digital Annual Conference continues July 15 and July 17 with sessions to help healthcare finance professionals handle revenue cycle and clinical care challenges amid the pandemic.
By Deborah Filipek, HFMA Senior Editor
News
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Revenue Cycle
HFMA members are putting their work-from-home situations and downtime due to stay-at-home directives to good use: 2,171 members passed HFMA certification exams between March 13 and April 27, 2020.
By Deborah Filipek, HFMA Senior Editor
How To
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Coding
Providers should make sure they fully understand various COVID-19 codes that can enhance payment from CMS and serve as important claims data.
By Emmel Golden, MD, FCCP, CCDS, and Brandy Kline, RHIA, CCS, CDIP
Fact Sheet
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Patient Access
HFMA presents a summary of CMS's final rule on interoperability and patient access to health data.
Article
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Revenue Cycle
Healthcare finance professionals can learn to continue to support their health system’s financial viability and ensure use of consumer-centric strategies during the COVID-19 pandemic at HFMA's Virtual Conference April 30.
By Deborah Filipek, HFMA Senior Editor
Fact Sheet
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Patient Access
Blog
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Financial Counseling
Many of the recently unemployed will qualify for a special enrollment period through the federal or state exchanges if the federal exchange hasn’t reopened.
By Chad Mulvany, FHFMA
Blog
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Medical Debt
HFMA’s Chad Mulvany says 31,000 lawsuits may seem like a lot but adjusted to an annual basis and the population of the study’s geographic area, the actual number is much smaller than one would expect.
By Chad Mulvany, FHFMA
Blog
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Charity Care
Despite tax-exempt hospitals providing $95 billion in total benefits to their communities in 2016 alone, it's anticipated that hospitals' tax-exempt status will see additional scrutiny.
By Chad Mulvany, FHFMA
How To
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Denials Management
Distinguishing coding denials from clinical validation denials is an ongoing challenge, and a good place to review processes.
By Malissa Powers, RHIT, CCS, CDIP, CICA
Article
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Revenue Cycle
Idaho-based St. Luke’s Health System is allowing payers to access patient records directly through their EHR.
By Erika Grotto, CHFP, CRCR
News
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Revenue Cycle
HFMA conference in New Orleans focuses on achieving a consumer-focused revenue cycle.
By Erika Grotto, CHFP, CRCR
Trend
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Revenue Cycle
A portion of the wasteful spending in healthcare can be curbed by automating repetitive tasks.
By Dan Hillman
News
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Revenue Cycle
HFMA’s new Consumerism Maturity Model serves as the blueprint for this year’s Revenue Cycle Conference.
By Erika Grotto
News
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Revenue Cycle
A national consultancy found large disparities in what hospitals charge and in the revenue they garner for most common services.
By Rich Daly, HFMA senior writer and editor
Trend
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Revenue Cycle
The December 2019 issue of Revenue Cycle Strategist features articles on building a chargemaster, new coding changes for 2020, revenue integrity, evaluating and management charges and patient financing.
How To
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Coding
In 2021, major evaluation and management code changes will be implemented for new and established patient office visits.
By Jennifer Swindle
Trend
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Coding
The 2020 ICD-10 updates not as significant as expected but there are new codes for new medical devices and related procedures.
By Kim Felix, RHIA, CCS
Trend
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Charge Capture
A strong revenue integrity program can help revenue cycle departments preserve the margins that further the mission of delivering high-quality healthcare.
How To
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Chargemaster
Revenue integrity requires proper staffing and bring activities to the front end of the revenue cycle.
How To
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Chargemaster
Review, analysis and revision are key components of a successful chargemaster review.
By Caroline DeLaCruz, RHIT, CCS-P, CPC, and Joseph J. Gurrieri, RHIA, CHP
Trend
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Financial Counseling
An overwhelming majority of respondents to a survey patient payment experience say they need more than 12 months to repay their healthcare costs.
Executive Roundtable
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Patient Financial Communications
A roundtable of healthcare revenue cycle leaders examines the pressing need to keep patients at the center of revenue cycle activities to increase yield and patient satisfaction while lowering administrative costs.
How To
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Revenue Cycle
To ensure patient payment plans are working well for an organization, leaders must analyze the true cost of servicing those plans.
By Mark Huebner
News
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Revenue Cycle
HFMA Seminars are among the major healthcare finance events taking place the week of Dec. 2.
By Rich Daly, HFMA senior writer and editor
Blog
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Patient Financial Communications
While the proposed health plan price transparency rule will likely be challenged, if it survives those challenges, it will be far more impactful on health spending than the negotiated charge-posting requirement.
By Chad Mulvany
Trend
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Revenue Cycle
The November 2019 issue of Revenue Cycle Strategist newsletter features articles on patient experience, coding and denials management.
How To
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Denials Management
Root causes for denials should be defined operationally to determine the level of analysis required internally.
By Denise Wilson and Tracey A. Tomak
Trend
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Patient Access
As patients pay more out-of-pocket healthcare costs, financial services influence patient experience, perceptions and actions.
By David Shelton
Trend
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Coding
Many healthcare coders are not just coding; they are evaluating the integrity of the codes and abstracted data associated with each patient.
Research & Reports
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Billing and Collections
Important learnings from a June 2019 HFMA Annual Conference intercept survey about how hospitals and health systems are making strides in proactively collecting patient payments.
Article
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Chargemaster
A leading chargemaster company discusses how its technology helps hospitals operate more transparently, price strategically and confidently run a compliant and efficient revenue operation.
Column
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Medical Debt
HFMA President and CEO Joe Fifer discusses current issues surrounding medical debt.
By Joseph J. Fifer, FHFMA, CPA
Executive Roundtable
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Patient Access
A roundtable of healthcare financial leaders explores strategies for optimizing the revenue cycle to reduce cost-to-collect, limit revenue leakage and meet patient and payer expectations.
News
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Bad Debt
Congressional negotiators are said to be close to a compromise on legislation that aims to end surprise medical bills.
By Rich Daly, HFMA senior writer/editor
Blog
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Billing and Collections
As negative press about patient billing shows no sign of slowing down, hospitals and health systems should re-evaluate the way they engage patients to resolve medical accounts receivable.
By Chad Mulvany
Policies and Practices
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Patient Financial Communications
These measurement criteria are based on the Patient Financial Communications Best Practices.
Policies and Practices
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Patient Financial Communications
This section of the Patient Financial Communications Best Practices addresses communication for all settings.
Policies and Practices
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Patient Financial Communications
This section of the Patient Financial Communications Best Practices addresses communication in advance of service.
Policies and Practices
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Patient Financial Communications
This section of the Patient Financial Communications Best Practices addresses communication at the time of service outside the emergency department.
Policies and Practices
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Patient Financial Communications
This section of the Patient Financial Communications Best Practices addresses communication in the emergency department.
Policies and Practices
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Patient Financial Communications
View frequently asked questions about the Patient Financial Best Practices and the Adopter Recognition Program.
Policies and Practices
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Patient Financial Communications
Show that you've implemented best practices for patient financial communications. Let HFMA recognize your organization as a Patient Financial Communications Adopter.
News
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Revenue Cycle
Register now at hfma.org/seminars to learn about the most pressing issues in the industry today during a two-day focused education Dec. 5 and 6 in Chicago.
By Erika Grotto
Trend
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Billing and Collections
Best practices can help healthcare providers avoid some of the pitfalls of trying to collect on patient debt.
By Nick Hut
Trend
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Revenue Cycle
The October issue of Revenue Cycle Strategist features articles on medical debt, robotic process automation, consumerism, patient experience and denials management.
How To
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Denials Management
Coders need to understand billing expectations, how the billing process works and how the revenue cycle is affected.
How To
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Denials Management
Successful denial management and prevention strategies require the right mix of people capable of handling the process from beginning to end.
By Keith Olenik
Trend
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Billing and Collections
Convenience factors, including easy-to-use payment options, have a significant impact on patients’ loyalty to healthcare providers.
How To
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Bad Debt
Medicare bad debt is a significant source of revenue leakage for hospitals and often is not adequately addressed.
By Jonathan Wiik
Trend
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Chargemaster
A charge management company discusses how it helps clients successfully manage charge processes, comply with changing coding and regulatory requirements, eliminate charge-related compliance risks and ensure accurate and appropriate reimburs...
Trend
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Revenue Cycle
Hospital labor costs have steadily increased amid consumerism and other trends, but some organizations are finding new ways to address the challenge.
By Rich Daly
Trend
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Billing and Collections
A recent analysis found that about 59% of patients in 2018 had an average out-of-pocket expense between $501 and $1,000 during a healthcare visit. This was a dramatic increase from 39% in 2017.
Trend
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Charge Capture
In an industry where “no margin means no mission,” revenue integrity is emerging as a tool and an initiative to enhance margin and preserve the mission of health systems.
How To
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Chargemaster
Reviewing billing edits and claim denials, as well as scheduling quarterly chargemaster reviews can help healthcare providers proactively identify potential challenges.
By Caroline DeLaCruz
News
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Patient Access
In 2018, 1.9 million fewer people were covered by some type of health insurance, and they were most likely former Medicaid enrollees, according to new federal survey data.
By Rich Daly, HFMA senior writer/editor
Executive Roundtable
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Self-Payment Collection
In this roundtable, several revenue cycle leaders discuss how they are tackling escalating patient responsibility, exploring the value of putting individuals on pathways toward payment that boost satisfaction and revenue.
Article
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Self-Payment Collection
In this article, Professional Credit discusses how it helps healthcare organizations effectively and positively engage patients throughout their healthcare financial journeys.
Article
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Revenue Cycle
Henry County Health Center, a critical access hospital in Mount Pleasant, Iowa, has earned two MAP Awards and made noticeable strides toward financial transparency.
By Erika Grotto
Article
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Revenue Cycle
Automating certain revenue cycle practices can help healthcare organizations improve performance.
By Eric Nilsson
Trend
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Charge Capture
HFMA is seeking input on your hospital's ability to group/capture APC data. This information is crucial to the work of HFMA’s chargemaster taskforce and will help HFMA provide guidance to CMS on transparency initiatives.
Trend
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Chargemaster
HFMA is gathering information to understand hospitals' costing capabilities at the inpatient discharge and outpatient visit/service level.
Trend
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Revenue Cycle
The July/August 2019 issue of Revenue Cycle Strategist newsletter features articles on payer EHR integration, price transparency, chargemaster strategies and KPIs for Medicaid eligibility.
Q&A
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Chargemaster
We are experiencing increased denials and loss of revenue as a result of chargemaster issues related to outpatient services coding. What steps can we take to identify the issues and clean up the chargemaster?
By Caroline DeLaCruz
Trend
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Billing and Collections
The shifting healthcare landscape is turning more patients into payers.
By David Shelton
Trendsetter
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Denials Management
A look at how one company is partnering with healthcare organizations to use data and technology to address the root causes of long-standing problems, including denials.
Blog
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Patient Financial Communications
The latest TransUnion Healthcare report shows a 12% increase in patient out-of-pocket costs while wages grew only 3%, proving the need for hospitals and health systems to engage patients in a discussion about their out-of-pocket responsibil...
By Chad Mulvany, FHFMA
Article
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Revenue Cycle
Given the challenges long-term care and skilled nursing facilities face, these provides require an effective collection process.
Case Study
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Revenue Cycle
Texas Children’s Hospital achieved financial and operational improvements after streamlining referral and scheduling processes to better accommodate providers and patients.
By Richelle Fleischer, CPA, MPH, Larry H. Hollier, Jr., MD, FASC, FAAP, and Angela Volk, MD
Case Study
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Revenue Cycle
For Texas Children's Hospital, a key to capitalizing on patient revenue opportunities identified by its patient access initiative was to reduce losses that arose from out-of-network insurers.