The data is clear – policymakers are making every effort to reduce healthcare costs, particularly as states struggle with significant budget deficits across the country. To do this, many state governments have elected to outsource the management of Medicaid and Medicare programs to managed care companies. According to Modern Healthcare, 34% of Medicare beneficiaries are now enrolled in a Medicare Advantage plan, which is administered by a private payer. Similarly, 77% of Medicaid beneficiaries are enrolled in some form of managed care plan.
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Tags: Health Information Management (HIM), Revenue Cycle Management (RCM), Accounts Receivable (A/R)
Outsourcing as a Solution for Revenue Cycle Management (RCM) Continues to Grow at a Rapid Pace
Posted on Wed, Feb 22, 2017 @ 06:00 AM
Facing lower reimbursements and shrinking margins, hospitals are exploring ways to capture more revenue. This has led an increasing number of hospitals across the nation to outsource their revenue cycle management to professional outsourcing companies. This trend was identified in a recent Black Book™ survey, which included responses from 1,309 hospital CFOs and business office leaders. The surveyed revealed that 39.8 percent of U.S. hospitals outsourced their complex claims and revenue cycle management to specialized vendors. That is up from 20.4 percent of hospitals in 2013.
Read MoreTags: Business Process Outsourcing (BPO), Revenue Cycle Management (RCM), Offshore Medical Billing, Offshore Medical Coding, Outsource Coding, outsourced coding, outsourced medical billing, Offshore Revenue Cycle Management, coding outsourcing, RCM Solutions
A recent article on the Radiology Business Management Association (RBMA) web site discussed consumer’s frustration with the cost of medical care as being at an all-time high as many purchasers of narrow-network, high-deductible and high-co-pay health plans are finding out that the benefits they get from their monthly insurance premiums are much more limited than they thought. One target of their frustration is “surprise” medical bills for services such as radiology, as well as other medical specialty services that a patient may receive from an out-of-network (OON) physician, while either receiving emergency care or a planned treatment at an in-network facility. It is an issue that has been covered by the likes of Consumer Reports and numerous other publications in recent years. In response, state legislators in nearly two dozen states are either considering or have already passed laws to protect patients from such unexpected/surprise bills.
Read MoreTags: Revenue Cycle Management (RCM), Patient Access Management, Offshore Medical Billing, Medical Billing BPO, outsourced medical billing, RCM Solutions
High Deductible Self-Pay Accounts Can Be a Major Threat to Revenue Cycle Management
Posted on Thu, Jan 26, 2017 @ 05:00 AM
According to data from the latest quarterly Crowe RCA Benchmarking Analysis: "Patient Financial Responsibility on the Rise,” healthcare providers could be facing a major threat to their revenue cycles. The analysis found that in the past year, insured patient financial responsibility has grown from 23.3 percent to 26.9 percent for outpatients and 10.2 percent to 12.1 percent for inpatients.
Read MoreTags: Revenue Cycle Management (RCM), Patient Access Management, RCM Solutions
Specificity of ICD-10 Coding Can Improve Reimbursements for Vaccine Administration
Posted on Wed, Jan 11, 2017 @ 10:15 AM
Administration of vaccines is an important part of healthcare delivery, and a critical contribution to preventive public healthcare. However, risings costs are making it difficult to align vaccine administration expenses with revenues.
There may be some relief to these rising costs and it comes from something that was once seen as a burden for medical practices. That relief comes in the form of ICD-10 coding.
Read MoreTags: ICD-10, Revenue Cycle Management (RCM), Medical Coding, outsourced medical coding, outsourced coding, coding outsourcing, Medical Coding BPO, RCM Solutions
AHA President and CEO Asks President-Elect Trump For "Steady as She Goes" Effort on Healthcare
Posted on Tue, Dec 20, 2016 @ 11:00 AM
By Nitin Thakor, GeBBS President & CEO
AHA President and CEO Rick Pollack recently sent a congratulatory letter to President-elect Donald Trump and asking him to go slowly on changes to our healthcare delivery system, particularly when it comes to the Affordable Care Act (ACA). This is good advice since healthcare represents a significant portion of the U.S. economy and essential public services. Pollack explained his case in terms that abrupt changes could lead to significant instability for patients, providers, insurers and others.
Read MoreTags: Revenue Cycle Management (RCM), Healthcare Revenue Billing, Best Practices, Insurance Billing Solutions, Medical Billing BPO, RCM Solutions, Revenue Cycle Solutions
A recent article in US News and World Reportexplained a little known fact of which most patients are completely unaware. A trip to the emergency room could cause a secondary injury to a patient’s wallet. Even if a patient goes to a hospital included in his or her health insurance network, if the emergency room physician who treats the patient is not part of the health insurance network, the patient will be responsible for a separate and unexpected bill.
Read MoreTags: Revenue Cycle Management (RCM), Healthcare Revenue Billing, Insurance Billing Solutions, Medical Billing BPO, RCM Solutions, Revenue Cycle Solutions
The Importance of Revenue Cycle Management in an Evolving Healthcare Delivery Environment
Posted on Tue, Dec 06, 2016 @ 06:00 AM
At the recent Becker's Hospital Review 5th Annual CEO + CFO Roundtable healthcare experts seasoned in the revenue cycle management (RCM) process discussed how their organizations and companies are working to stay ahead of the financial curve. As hospitals evolve into a value-based care delivery environment, RCM becomes even more critical.
Read MoreTags: Health Information Management (HIM), Revenue Cycle Management (RCM), Offshore Revenue Cycle Management, RCM Solutions, Revenue Cycle Solutions
How to Survive in a Value-Based Healthcare Delivery Environment
Posted on Thu, Oct 06, 2016 @ 11:00 AM
Black Book™, well-known for its accurate, impartial customer satisfaction surveys in the services and software industries, recently conducted its annual revenue cycle management outsourcing and software/technology user poll. They survey the clients of RCM vendors to provide insight into their customer experience in the functional areas of Billing, Charge Capture, Mid Process Coding, Claims Management, Reimbursement, Insurance and Payer Management, Payment Resolution and Collections, and collectively for end-to-end RCM software/technology and outsourced managed services.
Read MoreTags: Revenue Cycle Management (RCM), Offshore Revenue Cycle Management, RCM Solutions, Revenue Cycle Solutions
In their May 6, 2016 newsletter, the AMA stated that: “Patient care is the top priority and a source of passion for physicians, but making sure the business side of your practice is ‘healthy’ also can contribute to better outcomes and patient satisfaction.”
We couldn’t agree more!
Read MoreTags: Business Process Outsourcing (BPO), Revenue Cycle Management (RCM), Offshore Medical Billing, Medical Billing BPO, outsourced medical billing