“Revenue leakage” describes circumstances wherein a healthcare provider has supplied care to a patient but doesn’t collect payment. In general, it happens when accounts receivable (AR) continue to be unpaid for too long and are inadvertently overlooked. The longer an account receivable remains outstanding, the less likely healthcare providers are to retrieve payment, even in […]
A/R, Healthcare, Healthcare Denials, Healthcare Reimbursement, Healthcare Revenue Cycle, Medical Billing, Medical Billing Denials, RCM, RCM Challenges, RCM Essentials, RCM Support
Your Revenue Cycle Management Status Healthcare providers faced a tidal wave of challenges at the beginning of the COVID-19 pandemic, many of which endure consequences today. It’s not surprising that the revenue cycle did not evade these challenges. The shutdown and transfer to a generally virtual care world presented substantial bedlam that the revenue cycle […]
RCM, RCM Challenges, RCM Essentials, Revenue Cycle Challenges, Revenue Cycle Management, Revenue Cycle Management Concerns, Revenue Cycle Management Issues, Revenue Cycle Optimization
Healthcare Practices Face RCM Challenges Healthcare providers of all shapes and sizes are struggling to fine-tune their revenue cycle to adapt to changes in the billing world. Constant changes to the healthcare system have brought about a variety of new challenges for providers and patients alike. This is particularly true for smaller practices who must […]
Healthcare RCM, Medical Billing, Medical Billing Software, RCM, RCM Practices, RCM Support, Revenue Cycle, Revenue Cycle Challenges, Revenue Cycle Management, Revenue Cycle Optimization
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 […]
Medical Billing, Outsource RCM, RCM Outsourced, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Metrics, Revenue Cycle Optimization, Revenue Cycle ProcessCommon Revenue Cycle Management Mistakes Is Your Revenue Cycle Management in Top-Notch Condition? Let’s face it, we all make mistakes, even as veterans in revenue cycle management. Sometimes, though, our biggest mistakes are the ones right under our noses – the ones we simply don’t identify as mistakes because we’ve been making them for so […]
Healthcare, Healthcare Billing, Healthcare RCM, Medical Billing, Medical Credentialing, RCM, RCM Practices, RCM Support, Revenue Cycle Management
Revenue Cycle Management Challenges If a healthcare provider doesn’t set up an efficient billing process, it runs the risk of losing quite a bit of money. With high-deductible insurance plans becoming more widespread, patients are shelling out additional money out of pocket. Or, if the patient is uninsured or underinsured, problems arise since there’s not […]
A/R, A/R Process, A/R Recovery, Accounts Receivable, Healthcare Billing, Healthcare Outcomes, Healthcare Revenue Cycle, Measuring Healthcare Outcomes, Medical Billing, Medical Claims, Medical Revenue Cycle, Patient Billing, Patient Collections, Revenue Cycle Management
Healthcare Practices Save Money with Higher Accuracy of Medical Claims Reimbursement for medical practices has been impacted by numerous trends and healthcare industry changes over the past five to ten years. Medicare and Medicaid are constantly cutting physician reimbursement, third-party payers (UnitedHealth, BCBS, Humana, Anthem, Aetna, Cigna, etc.) have bargained for fee-for-service contracts with healthcare […]
Healthcare RCM, Healthcare Revenue Cycle, HIPAA, Medical Billing, Medical Claim Accuracy, Medical Claims, Outsourced Billing, Outsourced Medical Billing, RCM, Revenue Cycle Management, Revenue Loss
How Does Pricing Work in Medical Billing? The most familiar question medical billing companies hear, “What are your prices?” It’s an entirely reasonable question. After all, price is a sizable component in any business decision. In in the undermentioned content, we’ll try to clarify some of the misunderstandings surrounding medical billing service rates. We’ll also […]
Basics of Medical Billing, Billing, Healthcare Billing, Medical Billing, Medical Billing Service, Medical Provider Billing, Outsource Medical billing, Pittsburgh Medical Billing, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization
“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 […]
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
Choose a Qualified Medical Billing Group Since there are a large number of companies offering medical billing services, it’s often difficult for a healthcare provider to choose the best-fit, third party billing group for their organization. Healthcare providers have to ask billing companies the right questions on systems and services rendered, thereby making it much […]
Medical Billing, Medical Coding, Medical Credentialing, Pittsburgh Medical Billing, Pittsburgh Medical Credentialing, Revenue Cycle Management
It’s approximated that $3 trillion worth of medical claims are submitted every year to insurance companies, etc., with $262 billion worth of these claims denied. Approximately 65% of the denied medical claims are not resubmitted to the organization which denied the claim. Statistical data indicates that commercial payers are denying 58% of those claims. Appealing […]
Denial Management, Denials Managements, Denied Medical Claim Prevention, Denied Medical Claims, Medical Billing, Medical Billing Companies, Medical Billing Outsourcing, Medical Claim Denial, Medical Claims, Patient Billing, Patient Medical Billing, Revenue Cycle Management, upstream process