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Call: (412) 219-4789 | Fax: (866) 422-9277
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Revenue

Revenue Cycle Metrics for Healthcare Financial Success

May 3, 2024 / admin / Articles, RCM, RCM Challenges, RCM KPIs, RCM Metrics, RCM Optimization, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Cycle Process, Revenue Optimization
RCM Optimization

We all know how critical it is to keep a sharp eye on those revenue cycle metrics, right? Those numbers have the power to make or break your financial game. Understand them, optimize them – that’s the difference between rolling in dough or scraping by. But let’s keep it a hundred – digging into revenue […]

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RCM, RCM Challenges, RCM KPIs, RCM Metrics, RCM Optimization, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Cycle Process, Revenue Optimization

How Leading Providers Optimized Their RCM Performance

March 6, 2024 / admin / Articles, Case Studies, Denial Analytics, Denial Management, Denial Trends, RCM, RCM Case Studies, RCM Optimization, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Cycle Process, Revenue Integrity
RCM Case Studies

The healthcare revenue cycle management (RCM) process is a complex and critical set of activities that encompasses everything from patient registration and appointment scheduling to final payment collection. With rising costs, shrinking reimbursements, and increasing regulatory burdens, optimizing RCM performance has become essential for provider organizations to ensure financial viability and sustainability. We cover four […]

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Billing, Case Studies, Charge Capture, Denial Analytics, Denial Management, Denial Trends, Healthcare, Medical, Medical Billing, RCM, RCM Case Studies, RCM Optimization, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Cycle Process, Revenue Integrity

10 Key Medical Billing Challenges and Solutions

March 5, 2024 / admin / A/R, A/R Recovery, Articles, COB, Coding Accuracy, Healthcare KPIs, HIPAA Compliance, Patient Eligibility, Patient Insurance Eligibility, Payer Contracting, RCM, Revenue, Revenue Cycle Management, Timely Claim Submission
White Female Medical Billing Outsourced

The medical billing process is a complex and often daunting task for healthcare providers. From keeping up with ever-changing regulations and coding updates to managing denials and claim rejections, medical billers face numerous challenges that can significantly impact revenue cycle management and the financial health of a practice. We cover 10 key medical billing challenges […]

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A/R, A/R Management, Benefits Verification, COB, Coding Accuracy, Denial Management, HIPAA, HIPAA Compliance, Patient Eligibility, Payer Contracting, Revenue Cycle Management, Revenue Cycle Process, Revenue Optimization, Timely Claim Submission

Essentials of Revenue Optimization in Healthcare

March 4, 2024 / admin / Articles, Better Payer Contracts, Billing, Clinical Documentation, Patient Collections, Renegotiate Payer Contracts, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Integrity, Revenue Leakage, Revenue Optimization, Value Based Care, Value-Based Care, Value-Based Models
Revenue Cycle Management Coins

The healthcare industry is undergoing massive changes. With rising costs, declining reimbursements, and shift towards value-based care, healthcare providers face significant financial pressures. At the same time, patients demand superior access, quality, and lower out-of-pocket costs. To thrive in this environment, healthcare organizations must adopt a strategic approach to revenue optimization. Revenue optimization involves systematically […]

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Better Payer Contracts, Billing, Clinical Documentation, Healthcare, Healthcare Billing, Medical, Medical Billing, Patient Payments, RCM, Renegotiate Payer Contracts, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Integrity, Revenue Optimization, Value Based Care, Value Based System

Revenue Cycle Management Consulting: Maximizing Medical Revenue Capture

January 26, 2024 / admin / Articles, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Management (RCM), Revenue Cycle Management Challenges, Revenue Cycle Management Consulting, Revenue Integrity, Revenue Leakage
Revenue Cycle Management Coins

Revenue cycle management (RCM) is a critical component of running a successful and financially stable medical practice. However, with the complexity of medical billing and constantly changing payer rules, many healthcare providers struggle to manage their revenue cycle effectively. This results in lost revenue due to suboptimal reimbursement rates, denial rates, collection rates, and other […]

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Billing, Healthcare, Healthcare Billing, Medical, Medical Billing, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Management Consulting, Revenue Cycle Optimization, Revenue Leakage, Robotic Process Automation

Boosting Revenue Integrity: 7 Keys to Unlocking Efficient, Effective Medical Billing

December 18, 2023 / admin / Articles, Billing, Billing Revenue, Claims Management, Denial Management, Healthcare, Healthcare Billing, KPI, Medical Billing, Medical Billing KPIs, RCM, RCM Challenges, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Management (RCM), Revenue Cycle Optimization, Revenue Integrity
Medical Billing White Guy

Amidst an increasingly complex healthcare payer environment, medical billing has direct implications on the financial viability of providers to maintain daily operations and invest in advancing care. However, antiquated systems still relying on manual workflows struggle to effectively navigate critical revenue cycle processes and optimization in the modern digital era. The resulting claims denials, patient […]

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Getting Paid Faster: Strategies to Improve Cash Flow Cycles

October 16, 2023 / admin / Articles, Billing, Cash Flow Cycles, RCM, RCM Challenges, Reimbursement, Reimbursement Rates, Reimbursement Regulations, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Management (RCM), Revenue Cycle Management Challenges
Billing Cash Flow Cycles

For any medical practice, timely insurance reimbursement is essential for financial viability and supporting smooth practice operations. However, elongated claim payment cycles strain cash flow and necessitate borrowing to cover costs in the interim. Below, we explore techniques to accelerate payer payments and optimize the speed of the medical revenue cycle. Diagnosing Causes of Lagging […]

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Cash Flow Cycles, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, Medical Billing Strategy, RCM, Reimbursement, Reimbursement Rates, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization

Growing Risk of Claim Denials: How to Protect Your Practice

October 6, 2023 / admin / Articles, Billing, Billing Denied Claims, Claim Denials, Claim Rejection, Claim Status, Claim Status Updates, Denial Codes, Denial Management, Denial Prevention Strategy, Denial Trends, Denied Claims, Denied Medical Claims, RCM, RCM Challenges, Revenue, Revenue Cycle Management, Revenue Integrity, Revenue Leakage
Medical Claim Denied

For medical practices, claim denials have always been a fact of life when dealing with health insurers. However, trends show claim denial rates growing year over year, driven by increased utilization management efforts by payers. Denials directly impact practice revenues and the time/costs tied to appealing denials. Below, we take a gander at the factors […]

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Claim Denials, Denial Codes, Denial Prevention Strategy, Denial Trends, Denials, Denied Medical Claims, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, Revenue Cycle Management, Revenue Cycle Optimization

Understanding the Difference Between Medical Billing and Revenue Cycle Management

May 1, 2023 / admin / Articles, Billing AI, CPT, CPT Code, CPT Codes, Healthcare, Healthcare Billing, Healthcare Revenue, ICD-10, Medical, Medical Billing, RCM, Revenue, Revenue Cycle Management, Revenue Cycle Management (RCM)
White Female Medical Billing Outsourced

In the complex world of healthcare, managing the business side of things can often be overwhelming, especially for those new to the field. One common question that arises is the distinction between medical billing and revenue cycle management (RCM). Although the term “medical billing” has been around for a long time, RCM encompasses the entire […]

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CPT, Healthcare, Healthcare Billing, ICD, Medical, Medical Billing, Medical Billing Service, Medical Billing Software, Medical Credentialing, RCM, Revenue Cycle, Revenue Cycle Management

Revenue Cycle Management (RCM): The Key to Optimizing Healthcare Finances

February 2, 2023 / admin / Articles, RCM, RCM Challenges, Revenue, Revenue Cycle Management, Revenue Cycle Management (RCM), Revenue Cycle Management Challenges, Revenue Integrity, Revenue Leakage
White Female Revenue Cycle Management

The Key to Optimizing Healthcare Finances through Revenue Cycle Management (RCM) The Importance of Revenue Cycle Management (RCM) for Healthcare Providers’ Success Revenue cycle management (RCM) is a crucial process in the healthcare industry, as it involves managing all aspects of healthcare billing and payment processes, from patient registration to payment collections. RCM is critical […]

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Healthcare RCM, Healthcare Revenue, Healthcare Revenue Cycle, Medical RCM, Medical Revenue Integrity, RCM, RCM Challenges, Revenue Cycle Management, Revenue Cycle Management (RCM), Revenue Cycle Management Concerns

Emerging Trends in Revenue Cycle Management

January 10, 2023 / admin / Articles, Coronavirus, COVID, COVID Testing Billing, COVID-19, COVID-19 Billing, Healthcare, Healthcare KPIs, Healthcare Outcomes, RCM, Revenue, Revenue Cycle Management
RCM Optimization

In the wake of months of social distancing and virtual visits during the COVID-19 pandemic, patients are once again veering towards a need to see their physicians in person. As patient volume recovers, it’s a great time to take a look at a healthcare practice’s Revenue Cycle Management (RCM) program and make sure it’s still […]

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AI, Artificial Intelligence, Artificial Intelligence Healthcare, COVID, COVID-19, Data Security, Machine Learning, Medical Billing, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization

How Critical is Revenue Integrity in Healthcare?

December 28, 2022 / admin / Articles, Healthcare, Healthcare Revenue, Healthcare Revenue Integrity, Medical, Revenue, Revenue Integrity
electronic-claim-attachments

Is Revenue Integrity Critical in Healthcare? What is Revenue and Why is it Important? The exact wording may vary, but you can look for terms such as “gross revenue,” “gross sales,” or “total sales.” This figure is the amount of money a business brought in during the time period covered by the income statement. The […]

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Healthcare, Healthcare Revenue, Healthcare Revenue Integrity, Medical Revenue Integrity, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Integrity

10 Ways to Best Achieve Revenue Cycle Optimization

September 25, 2021 / admin / Articles, Medical Billing, Outsource RCM, RCM Outsourced, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Metrics, Revenue Cycle Optimization, Revenue Cycle Process
Concerned Healthcare Provider Owner

The healthcare industry is changing rapidly, creating a host of challenges for healthcare providers. Cutbacks in reimbursements, bad debt and regulatory reforms all affect a provider’s revenue. Moreover, the failure to recognize claim submission mistakes heightens the risk of inadequate reimbursement and even nonpayment. While concentrating on ever-pressing needs, it’s difficult for providers to spot […]

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Medical Billing, Outsource RCM, RCM Outsourced, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Metrics, Revenue Cycle Optimization, Revenue Cycle Process

Why Do Health Insurers Require Prior Authorization?

February 9, 2021 / admin / Articles, Healthcare, Medical Billing, Medical Credentialing, Medicare, Prior Authorization, Prior Authorization Process, Revenue, Revenue Cycle, Revenue Cycle Management, Utilization Management
Female Mulatto Doctor Prior Authorization

“This procedure will require prior authorization.” Words that no patient or healthcare provider wants to hear when they are ready to proceed with a doctor-approved procedure for a medical matter. However, it’s one of the utilization management tools that insurance companies have fostered to decide if specific prescribed procedures, services and medications are medically required […]

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Health Insurance, Healthcare, Healthcare Providers, Medical Billing, Medical Credentialing, Medical Practice, Medicare, Prior Authorization, Prior Authorization Process, Revenue, Revenue Cycle, Revenue Cycle Management, Utilization Management

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  • Behavioral Health
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  • Pharmacogenetic (PGx) Testing
  • Toxicology
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  • Allergy Testing
  • Speech Therapy
  • Skilled Nursing Facilities
  • Oncology
  • Pathology
  • Internal Medicine
  • OBGYN
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Practices Served

  • Behavioral Health
  • DME
  • Genetic Testing
  • Urgent Care
  • Pharmacogenetic (PGx) Testing
  • Toxicology
  • Substance Abuse
  • Allergy Testing
  • Speech Therapy
  • Skilled Nursing Facilities
  • Oncology
  • Pathology
  • Internal Medicine
  • OBGYN
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Recent Posts

  • One Big Beautiful Bill Act Outcomes

    Medicaid Changes Under The One Big Beautiful Bill Act

  • Indian Woman Physician Assistant Needing Credentialing

    What to Do If Your Medical Credentialing is Denied?

  • California Medical Billing, Credentialing

    California Medical Billing: Golden State’s Complex Healthcare Landscape

  • Medical Credentialing Engine Fueling American Healthcare

    Credentialing: Fueling America’s Healthcare Engine

  • Texas Medical Billing, Credentialing

    Texas Medical Billing & Credentialing Solutions

  • White Male Medical Credentialing Company Owner

    What Steps Do I Need to Take to Get Credentialed?

  • White Male Medical Doctor Typing at Machine

    How FHIR® Can Make Your Healthcare Business Smarter

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