Deep Dive: Is Your Practice in the Pre-Payment Review ‘Penalty Box’?
Pre-payment review means you must submit medical records with each affected claim before the payer will agree to pay or adjudicate claims. … Read More
September 6, 2024
Insights
Ideas, insights + industry updates
An End-to-End RCM Partner Is Not a Traditional Vendor
An end-to-end RCM partner shapes strategy throughout the revenue cycle, while traditional vendors operate at a task level. … Read More
August 29, 2024
Tracking Recently Enacted State Laws That Impact the Revenue Cycle
Many bills have been pending in state legislatures. Let’s take a look at what’s been recently enacted in three of those states. … Read More
July 29, 2024
Examining the Decision to Outsource
See why future-focused healthcare leaders view the revenue cycle as a value driver, not a cost center. … Read More
June 18, 2024
A Closer Look at Coding the Social Determinants of Health Risk Assessment
The new HCPCS code G0136 is meant to reimburse healthcare professionals for administrating an assessment of social needs/social risk factors. … Read More
June 10, 2024
Why Revenue Cycle Data Is a Key Differentiator
By mapping to outcomes, revenue cycle data models can yield swift, precise insights precisely when decisions matter most. … Read More
May 29, 2024
Managing Payer Friction Through Contract Negotiations
The fraught and evolving dynamics between payers and providers ultimately impact care delivery for patients … Read More
May 23, 2024
What Is a Reference-Based Pricing Plan?
Reference-Based Pricing plans pay based on a benchmark set by an administrator, rather than based on services rendered or value derived. … Read More
May 1, 2024
Revenue Cycle Impacts: 2024 State Legislation
State legislatures have already been busy this year. Here are some topics and bills Ensemble experts have been watching closely. … Read More
April 30, 2024
AI in Action: Revenue Cycle Management
There’s great opportunity for AI in healthcare RCM where models can be fine-tuned to reduce friction and more accurately predict outcomes. … Read More
April 11, 2024