FEATURED ARTICLES: REVENUE CYCLE MANAGEMENT
Does Meaningful Use Really Reduce Costs?
A report in a special edition of the American Journal of Managed Care seeks to answer the question all providers want to know By Katie Wike, contributing writer
Telehealth And Its Applications
Telehealth, sometimes called telemedicine, offers patients and physicians a way to communicate that bypasses the traditional office visit yet provides excellent care through the magic of webcam and smartphones. Telehealth began as a way to reach those in very remote areas who didn't have ready access to a doctor. Today, telehealth has crept into everyday healthcare, allowing doctors to extend their services, monitor chronic conditions, and possibly halt a health problem before it becomes serious. By Shannon Dauphin Lee
Lab Costs In EHRs Influence Providers Decisions
Study reveals showing lab costs as part of EHRs helps physicians make better decisions when ordering tests By Katie Wike, contributing writer
Implementation Aids In Improved RCM
Implementation of medical eligibility and financial counseling services expected to improve cash flow, reduce bad debt, and enhance patient advocacy By Wendy Grafius, contributing writer
CASE STUDIES & WHITE PAPERS
Healthcare Network Streamline Workflow, Increase Productivity, And Improve RCM With EDI
With the help of Centricity* EDI Services and Centricity Business— Enterprise Task Manager, St. Vincent Health has reduced cost to collect and lowered days in A/R, while increasing the number of claims per FTE.
Driving New Levels Of Business Performance With Revenue Cycle Efficiencies
Driving new levels of business performance with revenue cycle efficiencies.
The Need To Embrace Profit Cycle Management In Healthcare
Healthcare organizations have been operating under a fee-for-service model for many years. As such, financial leaders have become well versed in implementing revenue cycle management systems and processes that primarily focus on the money that comes into an organization.
Provider Readiness to Support Value-Based Payment Models
As health care reform gains momentum, the industry shift toward value-based payment models is accelerating. These emerging models compensate physicians based on patient care and outcomes rather than services rendered, putting the focus on quality over volume. As we learned in Availity’s latest research study, Health Plan Readiness to Operationalize Value-Based Payment Models, health plans expect the tipping point for these models will be reached in the next five years—when 50 percent or more of their business has transitioned from traditional fee-for-service arrangements to value-based compensation.
FROM THE EDITOR'S DESK
Goodbye Healthcare Technology Online, Hello Health IT Outcomes
In January 2014, we’re changing our name and brand to Health IT Outcomes. Here’s the story behind the name change and what you can expect from us going forward.
REVENUE CYCLE MANAGEMENT MAGAZINE ARTICLES
The Great ACO Experiment
Are ACOs the answer? Five Medicare Shared Savings Program ACOs share their perspectives on the positives, negatives, progress, and long-term sustainability of the program.
Speech Impacts ICD-10 Compliance
One healthcare organization describes how it is getting ready for the transition from ICD-9 to ICD-10 and how speech recognition will improve documentation productivity with EMRs.
Fighting For Provider Revenue
Healthcare reform, reimbursement cuts, sequestration, and RAC and Meaningful Use audits are new financial challenges cutting into provider revenue. How can you cope?
Release of chargemaster data proved that outlandish healthcare charges are the norm.
A Web-based billing software and services solution helped Adventist Health Medical Group cut its AR cycle by nearly 30 days.
By implementing a new medical claims clearinghouse, Pee Dee Orthopaedic Associates’ past-due claims outperform MGMA (Medical Group Management Association) standards.
Many radiologists believe Meaningful Use (MU) requirements don’t apply to them, but RMI (Regional Medical Imaging) is proving that MU will be instrumental in moving the radiology industry forward.
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.
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