Revenue Cycle Management

Maryland hospital has turned heads in the industry for its approach to revenue cycle and has consistently hit high benchmarks in patient access, revenue integrity, claims adjudication and management.

Transparency mandates make it tricky for health systems, as a procedure’s cost and what patients pay is very different.

Many providers are still utilizing technology that goes back decades and doesn’t have the functionality for an increasingly complex billing landscape, which raises the question: Are first-generation RCMs ripe for a "rip and replace" treatment?

It is important to both health plans and providers that the originator of an Electronic Funds Transfer (EFT) is easily and correctly identified, and that associated Electronic Remittance Advice (ERA) is sent in a timely manner, to eliminate the need for time-consuming follow-up.

Good managers don't live in boxes. And at Utah's Intermountain Healthcare, it's pretty much mandated that they break out of them, especially when it comes to improving revenue cycle management.

Some health systems are trying to help patients avoid high-cost bills altogether, by working with insurers to craft value-based plans that offer low out-of-pocket costs.

The acquisition gives Constellation a foothold in New York, New Jersey and Florida.

Collect financial information upfront, fight insurance denials, and send a combined bill from hospital and physician among advice for hospital finance staff.

The agencies say they will establish a 180-day waiting period before medical debt is added to someone's credit report.

Whether it's the change from fee-for-service to value-based reimbursements, or the looming switchover to ICD-10 coding, revenue cycle managers have a lot to deal with.