All our latest thinking on medical billing, medical coding, accounts receivable and denial management processes, robotic process automation, artificial intelligence, machine learning and more..
The US healthcare industry utilizes Prior Authorization as a means of ensuring optimal and cost-effective use of medical services in accordance with the insurance coverage of each patient. As a rule, healthcare providers must reach out to and obtain approval from the respective insurance companies before they can deliver certain medical treatments or services to their patients.
A typical healthcare provider in the United States is reliant on payors, such as insurance companies, to pay the medical bills of the patients who seek their care. Based on the services they deliver, they make their claims to the payor in prescribed format, requesting reimbursement in accordance with the coverage linked to the patient.
Clinical documentation improvement sounds like a silver bullet for effective revenue cycle management - an easy and straightforward solution for all RCM woes of healthcare providers - but it demands executive willpower, systemic transformation (in many cases) and most importantly, the cooperation of physicians, nurses, coders, and other healthcare personnel.
A global pandemic forced rapid shifts in an institution that already had been a focal point of calls for change: health care. The panelists brought out perspectives on the impact of COVID-19, emerging technologies in healthcare, hospital finances, shift to value-based care, rise of wearable devices and interoperability.
The post-pandemic path to recovery for hospitals and healthcare systems is steep with multiple challenges, including a severe shortage of clinical and revenue cycle labor, and unprecedented inflation. Initiatives such as value-based care, patient experience improvement, and process automation, on the other hand, are screaming for investments.
As with Neo, Revenue cycle leaders have a choice between the Red Pill The blue pill keeps you stuck in the enslaving ignorance of the status quo. Remaining in the same place and doing nothing significantly different is likely to not take you a great distance far. The red pill sets you free, allowing you to generate innovative ways to change the current landscape and move your revenue cycle to the next level. We provide you with some strategies on how we can help you navigate the challenges of RCM transformation.
The healthcare provider industry faces an unprecedented revenue cycle staffing shortage due to a combination of current issues, i.e., COVID-recovery to vaccination mandates to a real staffing shortage. It is time for revenue cycle leaders to look at these headwinds as an opportunity to create the revenue cycle of the future.
Revenue cycle leaders in hospitals and healthcare systems are facing multiple headwinds and trying to battle an ever-widening talent gap. They must make prudent choices as they strive to do more with less. Outsourcing and automation are two critical strategies that can help them bridge the talent gap. What's more, the unrelenting focus of the outsourcing services providers on managing the business processes by the numbers can improve reimbursements as well. Access Healthcare's best practice delivery engine provides the people, processes, and technology to help you do more with your revenue cycle.
