In the spirit of laughing at yourself (and the business), McKesson presented a series of cartoons at HIMSS17 that offer a lighter take on healthcare IT. Who says claims management is dry? Read the article
Why so serious? McKesson released some HIMSS17 humor to lighten the intensity of the annual HIMSS pilgrimage for HIT professionals. Read the article
On Monday at HIMSS17 in Orlando, RelayHealth Financial will unveil its new Healthy Hospital Index, an online service that allows hospitals to conduct a confidential assessment of their revenue cycle performance. Now, instead of trying to gauge financial performance in a vacuum–with no visibility into relevant national and regional KPIs and trends–financial executives can use Healthy Hospital’s analytics to benchmark their organization’s performance against that of peers. By simply entering some details about their revenue cycle performance, a customized “revenue health index” is generated with a comparative ranking of their hospital’s financial well-being. These insights can then be used to…
There's tremendous pressure on hospitals to reduce denial rates, and the problem is getting worse as claims processing becomes more complex. One way to reduce denials is to close common gaps that lead to medical necessity denials, which can account for as much as 5% of denials. CMSA Today shares a ten step process to that can have a quick and positive impact on your revenue cycle. Read the article
Pre-authorization is time consuming, costly, can delay care, and is a major source of claims denials. Those are just a few of the pre-authorization pain points reported in a survey of C-suite provider executives nationwide. This white paper reports and ranks pre-authorization problems, delves into the issues, and provides a path forward to improve pre-authorization to create more automated and streamlined system. Read now or download and read later
Pre-authorizations can be costly, time-consuming, frustrating for all involved, and can account for a large percentage of denials. It's no surprise that health care networks are increasingly turning to technology to automate the process. Fixing Healthcare’s Broken Pre-Authorization Screening & Verification Model lays out how automation and other necessary components can transform the pre-auth process to be faster, more efficient, and more economical. Read now or download and read later
Today McKesson Health Solutions announced that the Centers for Medicare & Medicaid Services (CMS) will continue their long-term use of InterQual Criteria for Medicare services auditing programs. Extending a 17-year relationship, CMS will continue to benefit from InterQual's evidence-based clinical decision support to help better manage patients as the industry transitions to value-based care. Read the news release
Everyone who thinks prior-authorization is a fast, efficient process, please raise your hand. No raised hands? No surprise. That’s because the prior auth process has been on the slow track for years, powered by paper, faxing, siloed software, and phone calls. Now payers can give provider networks a fast-track option for prior auth, where getting an authorization is as easy as requesting it through the payer’s care management portal. Payers like it because it reduces costs by freeing staff to tackle other things. Providers like it because it helps speed quality care. In fact, the only people who don’t like…
Among the processes that influence the healthcare revenue cycle, pre-authorization stands out—and not in a good way! Most provider organizations are still managing pre-authorizations the old fashioned way: manually, with paper, pen, fax, and phone. These ad hoc methods of securing and confirming payer approval for non-emergency medical services are error-prone and inefficient, and often lead to denied or rejected claims or, worse, delays in service. Few organizations file claims manually any longer. Why, then, are we still completing, filing, and managing pre-authorization requests as if it's 1980? Technology advancements finally make it possible for providers to standardize and centralize…
Pre-service authorization is a tedious, time consuming, and costly process for most providers. And issues related to pre-authorization are a major source of claims denials.
Those are just some of the pre-authorization pain points reported by HealthLeaders Media in a new survey of 158 senior clinical, operations, marketing, and financial leaders from non-profit and for-profit providers nationwide.
The study, commissioned by RelayHealth Financial, ranks pre-service authorization pain points and helps identify areas where improved processes and technology could help streamline payment and reduce denials.