Nearly two-thirds of denials are recoverable, and almost 90% are preventable. To accomplish this, provider organizations have to focus on the front end of the revenue cycle, such as registration and pre-service issues. They also need to address pre-auth denials from a holistic, organization-wide approach that includes the intersection of financial and clinical factors. Read the article
McKesson has announced that InterQual Criteria is now accessible through new cloud-based implementations of InterQual Online, InterQual Anonymous Review, and InterQual Transparency. The cloud access makes it easier to use the evidence-based decision making criteria—including Level of Care, Planning, and Behavioral Health criteria.
Mckesson’s InterQual Criteria can now be accessed on the cloud, making it easier and faster for customers to access objective, evidence-based medical and behavioral health clinical content. The criteria will be available through cloud-based implementations of InterQual Online, InterQual Anonymous Review, and InterQual Transparency. The secure, fast cloud access will help providers make appropriate care decisions across the medical and behavioral health levels of care.
McKesson announced that InterQual Criteria can now be accessed via cloud implementations of InterQual Online, InterQual Anonymous Review, and InterQual Transparency. What began over 40 years ago as thick printed books that users had to page through is now accessible on a variety of applications and platforms, from PCs to mobile devices to connected automated services and now, the cloud.
The Centers for Medicare & Medicaid Services (CMS) will continue their contract with McKesson Health Solution's InterQual Criteria for Medicare services auditing programs. CMS relies on InterQual's evidence-based clinical decision support to help better manage patients as the industry transitions to value-based care. Read the article
McKesson's RelayHealth Financial has partnered with the revenue recovery service provider, Emergency Recovery Inc. (ERI), to help providers recover unpaid fees. ERI will handle recovery efforts by directly working with the insurance companies, allowing providers to preserve positive relationships with patients. Read the article
A new service offered by RelayHealth Financial and Emergency Recovery Incorporated (ERI) will help hospitals recover funds that are underpaid or were deemed unrecoverable. The service allows hospitals to collect these funds without up-front fees or patient contact. Read the article
Hospitals dislike going after unpaid claims, especially when it means chasing down money from patients. So McKesson's RelayHealth Financial teamed up with Emergency Recovery Inc. to help providers find and recover millions in unrecovered revenue, without having to bother their patients. Read the article
"We're on the verge of a digital Renaissance in healthcare," predicts a McKesson VP, when asked by Becker's Hospital CFO to look into the near future. Six health care experts make their profound and practical predictions for revenue cycle management in 2017. Read the article