What Drives Friction Between Providers and Payers?
Delayed or denied payment due to avoidable friction between payers + providers is unsustainable and must be addressed. Here are 3 key causes.
Supporting Our Clients Against MA Plans’ 340B Inequities
Providers are being ignored by contracted and non-contracted MA plans in their efforts to obtain a remedy for 340B drug underpayments.
3 Proactive Steps to Counteract Payer Denials and Delays
Receiving accurate, timely reimbursement and reducing unnecessary administrative cost imposed by payers requires a proactive strategy.
Recent ACA Plan Growth Holds Risks + Opportunities for Providers
Healthcare providers must advocate for the extension of ACA plan enhanced subsidies to protect tenuous financial margins.
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.
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.
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.
How to Prevent Burnout During an Electronic Healthcare Record Implementation
There’s no need to go into an EHR implementation unprepared. Having a readiness program in place can help smooth the transition to a new EHR.
Tips for Providers Thinking of Going Out of Network
Understanding the implications and implementing a well-thought-out strategy is crucial to providers considering going out of network.
RCM Outsourcing Guide: Choosing the Right Partner Is Vital to Your Bottom Line
The right RCM outsourcing partner can impact your bottom line, optimize revenue streams and streamline operations for your organization.
What Is Patient Experience + Why Is it Important to Healthcare Providers?
Physicians, medical staff and organizations are responsible for a positive patient experience. Learn about the benefits this can provide.
How to Identify, Recover + Resolve Underpayments in Healthcare
Hospitals will leave money on the table if they don’t think holistically about identifying, recovering and resolving underpayments.