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The revenue cycle for hospitals and healthcare facilities is a cornerstone process, ensuring providers receive fair compensation for their invaluable services. While many in the industry focus heavily on the initial stages of this cycle, such as patient registration and claim submission, the final step — account reconciliation — completes the circle and cements financial stability.  This often-overlooked stage plays a pivotal role in maintaining accuracy, preventing revenue

When it comes to revenue cycle management, we often see articles around the top concerns of revenue cycle leaders of hospital systems. Here, we share what we consider the top five concerns of hospital revenue cycle vendors, and the factors you should take into consideration when selecting your Revenue Cycle Partner.  1. How do we ensure we stay compliant with data security and privacy measures: Hospitals deal with sensitive patient information and financial data every day. A

The Families First Coronavirus Response Act (FFCRA) mandated continuous Medicaid enrollment throughout the federal COVID-19 public health emergency (PHE) period for nearly all of those enrolled in Medicaid on or after the date of enactment on March 18, 2020, through the end of the month in which the PHE declaration ends.  In exchange for meeting these and other provisions, the FFCRA temporarily increased the federal medical assistance percentage (FMAP) by 6.2 percentage point

In recent years, the healthcare industry has been grappling with a concerning and persistent issue: the alarming increase in hospital medical claim denials. This trend is sending shockwaves throughout the medical community, as it not only impacts the financial stability of healthcare providers but also raises questions about the accessibility and affordability of healthcare for patients. In this post, we’ll delve into some of the reasons behind this surge in medical claim den

Healthcare organizations today face mounting pressure to optimize their financial operations amidst evolving regulatory landscapes and lingering pandemic effects. A robust Revenue Cycle Management (RCM) team is crucial for delivering quality patient care, investing in cutting-edge technologies, and supporting staff. However, building and maintaining such an in-house team can present significant challenges.  RCM staff augmentation offers a flexible, innovative solution to add

Did you know that behind the scenes of every hospital’s operation lies a significant financial challenge? Claims denials, a seemingly innocuous issue, can have a profound impact on the financial health of healthcare institutions.     Claims denials occur when insurance companies reject or partially pay for medical services provided to patients. These denials have far-reaching financial consequences. In the United States alone, hospitals are estimated to lose billions of dolla

In the fast-paced world of healthcare, effective accounts receivable (A/R) management is crucial for maximizing revenue and ensuring financial stability. As healthcare organizations navigate the complexities of billing and reimbursement, proactive strategies and continuous monitoring are essential to minimize bad debt and improve cash flow.  This blog post explores the importance of A/R analysis and recovery , sharing strategies to help you optimize your revenue cycle manage

Key Performance Indicators (KPIs) are important metrics to evaluate the performance of a hospital revenue cycle partner. These KPIs help you assess the effectiveness of their services and whether they are delivering value to your organization.  It’s important to work closely with your partner to define KPIs and establish clear benchmarks and goals. Regularly reviewing these metrics will help ensure that your hospital revenue cycle partner is meeting your expectations and help

Despite implementing sophisticated revenue cycle operations and maintaining experienced billing teams, healthcare organizations nationwide are facing an undeniable truth: denial rates continue to climb at an unprecedented pace. For CFOs and Revenue Cycle Directors managing multi-million dollar operations, this persistent challenge threatens immediate revenue and long-term financial stability.  The question then is: Does your current approach work?    The Hidden Costs of Your

Imagine a healthcare organization providing top-notch patient care, but behind the scenes, the revenue cycle team is grappling with a growing pile of aged accounts. The outstanding balances eat away at cash flow, and the administrative burden overwhelms the staff.   Sound familiar? Aged accounts management is a critical challenge faced by healthcare organizations across the nation, but there are innovative approaches to tackle this issue head-on. Let’s explore more.     Under

The changing employee and staffing environment is creating challenges with AR management during a time when cash flow is becoming more important than ever.  The age of insurance receivables is a measure of how long it takes for hospitals to collect payments from insurance companies. The average age of insurance receivables can vary widely for hospitals depending on various factors such as size of the hospital, payer mix, location and efficiency of revenue cycle management.  T