Insights

With one in three hospitals expected to continue operating with a negative margin, leaving money on the table is not an option, but it’s a billion-dollar issue.

Epic’s self-pay credits redistribution and automatic self-pay refund requests features could save valuable staff time and enhance patient satisfaction.

Three steps to begin removing barriers and building an effective and proactive communications strategy between pre-access and referring providers.

In our busy lives, we often tend to neglect our mental health needs because they may not be as apparent as our physical needs, or we may not prioritize them as highly. Starting with a healthy mindset about the importance of mental health is essential.

Since 2020, states were prohibited from performing routine Medicaid eligibility redeterminations or disenrollment to receive the 6.2% increase in federal Medicaid funding during the public health emergency (PHE). However, on March 31, the Biden administration ended this continuous coverage requirement in anticipation of the PHE coming to an end on May 11.

The higher the level of engagement, the more willing your employees are to deliver an outstanding experience to your patients. Engaged employees who are happy and interested in their roles will be much more invested in exceeding expectations of their leaders and your patients, friendlier when dealing with patients face-to-face or over the phone and more productive in their day-to-day responsibilities.

Even the singular step of creating and effectively overseeing an EAG is likely to have a significantly positive impact on employee engagement, morale and overall company culture. 

Historically, market share has dictated authority during contract negotiations between payors and providers, often giving payors the upper hand. So how can providers of any size level the playing field? They must know what provisions to include in their contracts, leverage comparative data to change payor behavior and use price transparency rules to their advantage.

Insurance companies are increasingly denying payment of medical claims received from healthcare providers. A recent report found that 11% of claims were denied in 2022, which equates to 110,000 denials for the average-size health system. The rate of prior-authorization denials doubled in the past year alone and request-for-information denials, which essentially serve as pre-pay audits for payors, are increasing rapidly.

Healthcare organizations share a common mission: improve patient outcomes and support community wellness. But without strong revenue cycle performance, that mission becomes impossible. And with thousands of payor updates per year, the process for getting paid is becoming more complex and labor intensive. The result? Hospitals suffer losses while payor profits soar. Something is broken. The solution? Outsourcing your revenue cycle function.