States’ Progress on Health Coverage and Access to Care
I recently read the latest Commonwealth Fund census report examining how healthcare coverage and access have fared under the ACA. The report specifically focused on the time period between 2013 and 2016. One compelling take away is that fewer adults skipped doctors’ visits due to cost during this time. Thus, creating more access to healthcare […]
A Renewed Focus on Denial Management
Hospitals are losing an estimated 3% of net revenue on denials and the cost of reworking claims is an average of $25 per claim. Hospitals are renewing their focus on denial management by analyzing their current processes and tweaking those gaps. Taking another look at your processes, workflows and automated tools significantly helps your organization’s […]
Is this the new “normal”? – Survey indicates Denials cost the average hospital $3.5M
According to the Advisory Board’s latest revenue cycle survey, denials cost the average hospital $3.5M a year. The biennial survey included information provided by senior executives at 90 hospitals and health systems, as well as data from nearly 300 additional healthcare organizations. According to the survey, the number of denials hospitals wrote off as uncollectable […]
Tips for Avoiding Hospital Underpayments and False Variances
Hospital underpayments are nearing 100 billion dollars nationally which explains why Executives are taking notice. Every day, hospitals are underpaid at rates which are in variance to their payer contracts. Many of these underpayments go unnoticed making it difficult to recover. At the heart of underpayments is a hospital’s Contract Management System. Whether you are […]
Parathon Launches New Look and Feel to Software
Parathon Launches New Look and Feel to Software Parathon, the original full-scale healthcare Revenue Cycle Management (RCM) data integrator, has announced the release of a fresh new look and feel to its Parathon® Web Tool. Parathon first focused on updating its name and website, www.Parathon.com, for its rebranding campaign which began in July 2017. Once […]
Next Generation Revenue Cycle Trends
With shifting paradigm in the regulatory environment, valued-based reimbursement, healthcare consumerism, and long term sustainability is on the minds of healthcare executives. In planning strategic initiatives, there are key improvement opportunities for providers to address. Key Improvement Opportunities: Optimize revenue cycle technology – finding a middleware vendor that can integrate with all HIS systems and […]
EMR/EHR Systems: Increasing Your ROI
According to a recent survey by Health Catalyst 61% of healthcare officials reported “terrible” to “poor” ROI on EHRs, with less than 1% listing, “superb” as a response. While traditional EMR/EHR systems promise efficiency and some can deliver, where they fall woefully short is in delivering ROI. It’s no wonder that healthcare finance officers across […]
Increase Your Net Revenue with ED Triage Claims Payments
States using the ED Triage payment methodology by Medicaid and Managed Medicaid payers often have hidden and challenging reimbursement opportunities. THE CHALLENGE: High volume, low dollar accounts, which staff does not have the bandwidth to pursue or sees as low priority. Confusing or absent denial codes shown on EOB do not indicate the reason for […]
The True Cost of Denials
A recent study found that hospitals lose around $262 billion annually on claims that are denied by insurance Providers. In fact, 9% of all claims submitted are initially denied, and the cost to contest these claims averages around $118 per claim. Denials can occur for a multitude of reasons, which makes pinpointing the exact reason […]
How the ACA helps us better understand consumer behavior
The word is out, and it’s no surprise. When it comes to selecting health insurance plans, consumers prioritize price more than any other factor, including brand or size of network. According to a recent study by Leavitt Partners, consumers searching for individual plans on the Healthcare Marketplace from 2014-2016 were more likely to cite cost […]
