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revenue cycle

Epic PB: Understanding and Improving Your Pre-AR (and the “Pre” Pre-AR You May Not Even Know About)

2024-02-14T06:54:59-05:00

Epic Pre-AR equates to unposted charges that are held in Charge Review work queues (WQs). Fluctuations in Pre-AR are common yet can have a significant impact on your actual AR days, gross revenue, cash flow, visit statistics, provider productivity/compensation, and even patient care if providers do not complete critical documentation and close encounters in a timely manner. In the most ideal world, clinic charges are documented, coded, and posted the same day the service [...]

Epic PB: Understanding and Improving Your Pre-AR (and the “Pre” Pre-AR You May Not Even Know About)2024-02-14T06:54:59-05:00

An Integrated Approach to a Case Management Denial Prevention Program

2024-02-06T07:23:36-05:00

Case Management (CM) plays a pivotal role in ensuring the Revenue Cycle (RC) operates efficiently and effectively by improving patient care and patient relationships, reducing denials, and enhancing the organization’s overall financial performance. Within the denial reduction scope, an effective Case Management department can pre-emptively address encounters that have a higher likelihood of medical necessity denials to ensure streamlined compensation.  According to Change Healthcare, their research shows nationally that medical necessity denials [...]

An Integrated Approach to a Case Management Denial Prevention Program2024-02-06T07:23:36-05:00

Navigating Net Revenue and Revenue Cycle Performance: Strategies for Alignment

2023-12-21T12:24:26-05:00

In the intricate dance of healthcare financial management, the connection between Net Revenue and Revenue Cycle performance is often overlooked or misunderstood. Finance teams may wield their analytical magic at month-end, declaring success or failure against budgets, while the Revenue Cycle, if engaged, grapples with specific encounter-level questions without full understanding of financial model mechanics. The result? A disjointed process that hinders a holistic and common understanding of performance. In this blog [...]

Navigating Net Revenue and Revenue Cycle Performance: Strategies for Alignment2023-12-21T12:24:26-05:00

Successfully Managing Your Remote Revenue Cycle Team

2023-10-11T20:49:49-04:00

The field of revenue cycle management in healthcare has been rapidly changing over the years leading to an increasing number of revenue cycle teams adopting alternative work arrangements. This trend was accelerated by the pandemic, which forced revenue cycle staff to transition to working remotely. While remote work offers advantages such as flexible schedule and potential money savings, it also presents challenges when it comes to managing a remote team. In this [...]

Successfully Managing Your Remote Revenue Cycle Team2023-10-11T20:49:49-04:00

Preparing for a Seamless EMR Transition: Essential Steps for Revenue Cycle Success

2023-10-21T16:52:25-04:00

Are you considering replacing your EMR system? Before diving into a new installation for your Revenue Cycle, it's crucial to explore several key prerequisites. While these topics often arise during the implementation process, addressing them beforehand can significantly streamline your EMR transition. While you don't need to finalize every detail before implementation, having a clear understanding of your current state, payer regulations, revenue cycle pain points due to your existing system, and [...]

Preparing for a Seamless EMR Transition: Essential Steps for Revenue Cycle Success2023-10-21T16:52:25-04:00

Managing Your Outsourced Revenue Cycle

2023-10-21T16:50:08-04:00

When healthcare organizations outsource their Revenue Cycle Management (RCM), they can “potentially” experience noteworthy cost savings and improved efficiency. Nonetheless, managing an outsourcing partner and achieving desired outcomes comes with its own set of challenges and oftentimes significant setbacks in performance.  There are several tactics organizations can implement to mitigate some of these risks. To maximize a successful partnership, healthcare organizations must establish Service Level Agreements (SLAs) that are clear, measurable, and [...]

Managing Your Outsourced Revenue Cycle2023-10-21T16:50:08-04:00

Do You Really Know Your AR?

2020-08-19T08:55:24-04:00

Cliff Notes Much of what we consider our accounts receivable will never be collectedInaccurate variance logic will continually over/under represent ARHospitals need to evaluate the likelihood of a positive outcome and ensure staff work corresponding populationsVendors should be utilized solely on a performance basis to collect on aged AR What is my AR, really? In-house unbilled, discharged not final billed (DNFB), follow-up, variance, denials, self-pay, bad debt. These are all populations that [...]

Do You Really Know Your AR?2020-08-19T08:55:24-04:00

Accounts Receivable Outsourcing – 3 Keys to Making a Decision

2020-08-19T09:01:14-04:00

Three Keys to Outsourcing Success In our last newsletter, we introduced the blog series: Why AR Outsourcing Fails and How to Avoid Common Pitfalls. We introduced two primary dangers with outsourcing arrangements: Hospitals that outsource frequently relinquish full control to the vendor and end up in an “out of sight out of mind” situation Vendors many times interpret “silence” from the hospital as positive reinforcement for the program they have implemented There [...]

Accounts Receivable Outsourcing – 3 Keys to Making a Decision2020-08-19T09:01:14-04:00

Why Accounts Receivable Outsourcing Fails & How to Avoid Common Pitfalls

2020-08-19T08:55:51-04:00

Your internal self-pay team can’t handle the increasing volume of calls.  You’re aged insurance accounts receivable (AR) continues to increase.  Or maybe your internal resources just don’t have the necessary expertise (or time) to work a specialty population like out-of-state Medicaid or third-party liability. Any of these scenarios can cause you to start down the path of outsourcing a revenue cycle function or segment of your AR.  This is a process that [...]

Why Accounts Receivable Outsourcing Fails & How to Avoid Common Pitfalls2020-08-19T08:55:51-04:00
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