Here’s What’s Happening At HIMSS16

Here’s What’s Happening at HIMSS16

  • February 27, 2016

  Unless you've been keeping residence on the International Space Station, you know that HIMSS16 is next week. RelayHealth Financial will be there in force, along with an estimated 60,000 other healthcare industry professionals. The annual HIMSS trade show is always a busy week with a lot to take in. For fans of revenue cycle management topics, here's a bundle of HIMSS-related activities and content we've produced just for you. Five Strategies to Keep Revenue on Track During EHR Conversions You’ve heard the horror stories. Now hear how making clinical and financial data “inseparable” can help ensure a smooth migration…

Read More
Prior Auths Are Here To Stay

Prior Auths are Here to Stay

  • May 21, 2015

Does the transition to value-based care mean the end of prior auths? Managed Healthcare Executive posed that question to several industry leaders, including our own Laura Coughlin, vice president of clinical development at McKesson Health Solutions. Read what these executives had to say.  

Read More
McKesson InterQual® Introduces Clinical Decision Support For Autism Spectrum Disorders

McKesson InterQual® Introduces Clinical Decision Support for Autism Spectrum Disorders

  • January 20, 2015

Today we announced the release of Applied Behavior Analysis (ABA) criteria for autism spectrum disorders in our Behavioral Health InterQual® solution. Demand for autism treatment is growing, as are associated treatment costs. In 2014, the CDC reported 1 in 68 U.S. children were identified with autism spectrum disorder, a 30% increase over their 2012 estimate. And JAMA Pediatrics estimates the average lifetime cost for an autism spectrum disorder is $2.4 million. Part of the increase in demand can be attributed to Federal and state healthcare reforms that mandate greater access to treatment, coupled with more Americans now having health insurance as a result of the ACA. Read the…

Read More
True Fax Facts In Healthcare Reimbursement

True Fax Facts in Healthcare Reimbursement

  • January 14, 2015

If you’re laughing, you know it’s true. And, in fact, this cartoon is based on a true story we overheard at a trade show. Obsolete practically everywhere else, the fax machine is alive and well in healthcare reimbursement. It’s emblematic of why many organizations struggle with costly, burdensome, error-prone administrative work when processing authorization requests or claims. Fortunately, payers and providers can reduce administrative costs with cloud-based utilization management and coverage solutions that support medical appropriateness reviews at the time of decision, such as Clear Coverage. Our clients can fully automate up to 40% or more of their prior authorizations.…

Read More
It’s Time For A New Value-Based Utilization Management Model

It’s Time For A New Value-Based Utilization Management Model

  • January 12, 2015

Today The Morning Consult featured Matthew Zubiller's description of a next-generation UM model that helps payers and providers collaboratively measure, manage, and refine high-quality care delivery while reducing administrative costs. Read how Zubiller's UM model works while helping balance stakeholders’ concerns

Read More
Why You Need To Start ICD-10 Testing Right Now

Why You Need to Start ICD-10 Testing Right Now

  • December 18, 2014

In the latest edition of ICD-10 Watch,  Joshua Berman, Director of Analytics and ICD-10 at RelayHealth Financial, discusses what payers and providers should do now to ensure they're ready for ICD-10 tomorrow. He advocates end-to-end testing and transparency from payers, so providers who are not being tested can learn from those that are. He also discusses forming partnerships to optimize testing results, and advises providers on what they should be testing. Read the whole column

Read More