Healthcare Revenue Cycle Management, Reimbursement, HIPAA, and Insurance Information Gathering Resources Healthcare Revenue Cycle Management, Reimbursement, HIPAA, and Insurance Information Gathering Resources

FEATURED ARTICLES: REVENUE CYCLE MANAGEMENT

  • Why Healthcare Should Provide Treatment Cost Information

    As part of revenue cycle management, patient financials — the ability to discuss treatment costs at the time of service and helping patients understand why visits cost what they do — is crucial and a growing challenge in healthcare IT. Savvy healthcare consumers are demanding more information about all aspects of their medical care and are especially interested in obtaining up-front information about costs in an effort to mitigate increasing premiums and high deductibles.

  • Choosing The Right Payment Mix For Your Practice

    When it comes to money management, most physicians refrain from hiding their money under a mattress and instead take advantage of various financial options that balance easy availability and long-term return on investment and which streamline their daily routine.

  • The Total Cost Of Not Managing Outsourced Vendors

    Before high-deductible health plans and the expansion of IRS and CFPB engagement in patient finance, managing uninsured accounts and patients with responsibility after insurance was relatively straightforward.

More Featured Articles

CASE STUDIES & WHITE PAPERS

  • Four Steps To Develop, Implement, And Operationalize A Bundled Payment Strategy

    In the continuing effort to increase quality and decrease costs, health plans and providers are shifting from volume-based care (fee for service) to a value-based reimbursement structure (fee for value). Value-based reimbursement promises benefits to patients, providers, and health plans, as it encourages delivery of high quality care at the lowest cost, largely by improving clinical and administrative efficiency.

  • Bundled Payments For Care Improvement (BPCI) Benchmark Survey

    Caradigm recently conducted a survey of healthcare organizations in order to better understand how providers are approaching bundled episodes of care. Although some providers have been piloting bundled episodes for several years, most are still in the early stages of refining their strategies and increasing their participation in The Centers for Medicare and Medicaid Services (CMS) Bundled Payment for Care Improvement (BPCI) program.

  • Unified Reimbursement Strategy: Implementing Common Ground Among Next-Generation Reimbursement And Quality Systems

    We may look back on the 25-year span following the change of the millennium as one of the most densely populated periods of healthcare regulation ever seen in the history of the United States. Every year, individual clinicians, private practices, and health systems are bombarded with new coding, compliance, quality, and reimbursement models, making staying ahead of the curve in terms of overall strategy nearly impossible. Executives, physicians, and healthcare experts would probably agree that it is impossible to maintain a status quo level of performance if your strategy is one of pure reaction to each new deadline from the Department of Health and Human Services.

  • Revenue Cycle Management: Is Your Process Under Control?

    When it comes to the revenue cycle, do you have it covered, or could it be time to consider turning over certain processes to a trusted partner?

More Case Studies & White Papers

FROM THE EDITOR'S DESK

  • The Problem With Consumerism In Healthcare
    The Problem With Consumerism In Healthcare

    Many industry leaders championed a free market approach to healthcare during the 12th Annual World Health Care Congress last week. Here are a few key reasons why I don’t think this model is “the fix” our industry so desperately needs.

More From The Editor

RCM (REVENUE CYCLE MANAGEMENT)

At its core, revenue cycle management (RCM) is the process that ensures healthcare providers are efficiently reimbursed for the services they provide. The most significant parts of the process includes tracking patient claims, collecting payment for each claim, and handling claims that are denied for various reasons. To accomplish this goal, RCM systems must tightly integrate claims data, clinical data and IT infrastructure.

RCM systems track patients’ interactions with providers as they enter a hospital or arrive for a scheduled physician’s appointment. From that initial contact point, the RCM system tracks claims at every point on its way to resolution. This allows the process to be monitored by providers and gives them the ability to address any issues or delays that might arise. This RCM transparency ensures a steady revenue stream for healthcare providers. 

RCM includes insurance information gathering, insurance eligibility verification, payment guarantor identification, ICD-10 claims coding, co-pay collection, and medical necessity verification to ensure timely and accurate payment.

INDUSTRY EVENTS

Cell Therapy: Process Design Considerations To Support Commercialization February 27, 2018
1pm-2:30pm EST, Online Training
Sara Khairy March 29 - 31, 2018
Dubai
SARA KHAIRY April 4 - 7, 2018
Dubai
Middle East Pharma Cold Chain Congress April 17 - 19, 2018
Dubai
More Industry Events