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Revenue Cycle Management (RCM) is a critical aspect of healthcare administration that involves managing the financial transactions and interactions between healthcare providers, insurance companies, and patients. The process begins with patient registration and ends with the collection of payment for services rendered. It encompasses everything from verifying patient insurance eligibility and creating medical claims to posting payments and handling denials and appeals. Effective revenue cycle management is essential for financial stability and long-term success for hospitals. This blog will discuss how hospitals can benefit from outsourcing revenue cycle management services and the key components of a successful revenue cycle management program. Benefits of Revenue Cycle Management Services for Hospitals Outsourcing revenue cycle management services can provide numerous benefits to hospitals. These services can help hospitals streamline their billing processes, improve financial p

You can expect major changes to  hospital billing  this year thanks to the pandemic and shifts in patient behavior – but one of the most important that hospital and health system leaders should pay attention to is changes in use of outpatient services. An analysis from the Guidehouse Center for Health Insights and Healthcare Financial Management Association (HFMA) addressed hospital and health system leaders including CEOs, CFOs, COOs, and other executives from 182 hospitals for insights into what they expect in the near future. It found that a full 95% of the executives surveyed expected higher outpatient volumes in 2023. As much as 40% of leaders expected increases of 10% or more. But this shift isn’t happening on its own and those in charge of  hospital coding and billing  should pay attention. 41% of the leaders surveyed expected lower inpatient volumes at the same time, with 17% expecting that drop to be 10% or higher [1]. What’s Behind the Shift in Hospital Revenue Cycle

  Physician billing companies   know a secret – keeping on top of risks in   physician billing services   is one of the most effective ways to keep cash flows healthy and practices functioning at their best. That’s why we’re going to walk you through the biggest risks to  physician billing  right now in 2023. Volume and Resource Fluctuations Continue While the worst of the pandemic-related volatility is likely behind us,  physician billing  will still need to adjust for unpredictability. This is because physician practices are dealing with COVID-19 challenges in addition to the waste and abuse issues that were entrenched well before the pandemic. So now physician offices are dealing with yesterday’s problems on top of longer visits, more visits for therapies and early refills, COVID-19 diagnoses, and disbursement of excess pharmacy and  durable medical equipment . These things make billing volatile and complex and are why many practices are considering working with  physician billing s

 The COVID-19 Public Health Emergency (PHE) is ending as of May 11, 2023, and  home health billing  leaders should be preparing. While there is some time left, the transition won’t be as clear cut as many might think, with some waivers and reimbursements changing immediately and others taking place over the coming months and years. This means that now is an excellent time to start gathering information and creating a plan to transition your  home health billing  practices out of an active pandemic and into the new normal that’s coming around the corner. To get you started, we suggest the provider-specific fact sheet presented by The Centers for Medicare & Medicaid Services (CMS), specifically for home health agencies, which we’re reviewing here [1]. Payments Are Decreasing Overall Reimbursements for multiple methods of addressing the pandemic will be phasing out as the PHE ends. COVID-19 vaccines will continue to be reimbursed by CMS at about $40 per dose when rendered in outpatien

You can expect major changes to  hospital billing  this year thanks to the pandemic and shifts in patient behavior – but one of the most important that hospital and health system leaders should pay attention to is changes in use of outpatient services. An analysis from the Guidehouse Center for Health Insights and Healthcare Financial Management Association (HFMA) addressed hospital and health system leaders including CEOs, CFOs, COOs, and other executives from 182 hospitals for insights into what they expect in the near future. It found that a full 95% of the executives surveyed expected higher outpatient volumes in 2023. As much as 40% of leaders expected increases of 10% or more. But this shift isn’t happening on its own and those in charge of  hospital coding and billing  should pay attention. 41% of the leaders surveyed expected lower inpatient volumes at the same time, with 17% expecting that drop to be 10% or higher [1]. What’s Behind the Shift in Hospital Revenue Cycle Hospital