Delayed or denied payment due to avoidable friction between payers + providers is unsustainable and must be addressed. Here are 3 key causes. … Read More
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Supporting Our Clients Against MA Plans’ 340B Inequities
Providers are being ignored by contracted and non-contracted MA plans in their efforts to obtain a remedy for 340B drug underpayments. … Read More
3 Proactive Steps to Counteract Payer Denials and Delays
Receiving accurate, timely reimbursement and reducing unnecessary administrative cost imposed by payers requires a proactive strategy. … Read More
Recent ACA Plan Growth Holds Risks + Opportunities for Providers
Healthcare providers must advocate for the extension of ACA plan enhanced subsidies to protect tenuous financial margins. … Read More
Deep Dive: Is Your Practice in the Pre-Payment Review ‘Penalty Box’?
Pre-payment review means you must submit medical records with each affected claim before the payer will agree to pay or adjudicate claims. … Read More
An End-to-End RCM Partner Is Not a Traditional Vendor
An end-to-end RCM partner shapes strategy throughout the revenue cycle, while traditional vendors operate at a task level. … Read More
AI in Action: Revenue Cycle Management
There’s great opportunity for AI in healthcare RCM where models can be fine-tuned to reduce friction and more accurately predict outcomes. … Read More
How to Prevent Burnout During an Electronic Healthcare Record Implementation
There’s no need to go into an EHR implementation unprepared. Having a readiness program in place can help smooth the transition to a new EHR. … Read More
Tips for Providers Thinking of Going Out of Network
Understanding the implications and implementing a well-thought-out strategy is crucial to providers considering going out of network. … Read More
RCM Outsourcing Guide: Choosing the Right Partner Is Vital to Your Bottom Line
The right RCM outsourcing partner can impact your bottom line, optimize revenue streams and streamline operations for your organization. … Read More