Rethinking Denials Management

Rethinking Denials Management

  • March 16, 2017

Most provider organizations take an administrative approach to managing claim denials. Maybe that’s why they’re not collecting as much as they should. It turns out that most denial management programs have several flaws that, if corrected, can help close the gap on the 90% of claim denials that are preventable. This white paper explores a new holistic approach to denials management that intersects financial and clinical factors. See how some of the most prevalent causes of denials can be isolated and eliminated more effectively. Read now or download and read later

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Reinventing Claims Management For The Value-Based Era

Reinventing Claims Management for the Value-Based Era

  • February 17, 2017

Claim denials sap the life out of providers, leading to lost or delayed revenue, wasted time, and tons of frustration. And it's only getting worse as providers switch to more complex value-based payment models. To reduce denials, provider organizations need to evolve from putting out fires one denial at a time to a systemic approach that blends claims management and denials management into a holistic process. Doing so can have a significant impact on any provider organization’s bottom line. Learn more in this new paper, Reinventing Claims Management for the Value-Based Era. Read now or download and read later

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Patient Access And Revenue Cycle Analytics–Perfect Together, Yet Often Ignored

Patient Access and Revenue Cycle Analytics–Perfect Together, Yet Often Ignored

  • February 17, 2017

Providers don't usually think of patient access and revenue cycle analytics as a pair, but when you bring them together to guide process improvements, it can lead to significant savings -- potentially millions of dollars for a single facility. Here are just a few areas you can improve by pairing these to crucial pieces of the revenue cycle puzzle: Secure timely reimbursement from insurers and patients Reduce claims denials by drilling down to root causes Identify front-end registration and eligibility issues Learn more in this new guide, Patient Access and Revenue Cycle Analytics–Perfect Together, Yet Often Ignored. Read now or download and…

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Reinventing Utilization Management To Bring Value To The Point Of Care

Reinventing Utilization Management to Bring Value to the Point of Care

  • February 17, 2017

It's time to bring utilization management into the 21st century. A more collaborative, automated UM model could create a bridge between the current system, where authorizations happen after care decisions, and real-time communication between payers and providers that provides immediate decisions at the point of care. That bridge is what we call an "exception-based utilization management model." New technology can help payers identify which providers are getting approvals, for which care events, and how often. Then, using that knowledge, most care events can be automatically authorized, letting the payer limit their focus to the outliers. And even then, many of those…

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Four Steps To Develop, Implement, And Operationalize A Bundled Payment Strategy

Four Steps to Develop, Implement, and Operationalize a Bundled Payment Strategy

  • February 17, 2017

Health plans and hospitals see bundled payment as the fastest growing value-based payment model. They predict that the model will account for 17% of reimbursements in the next five years. But where do you begin? Start with this four-step guide, Bundled Payment 101: A Guide to Getting Started Quickly. The steps include analyzing data to identify episodes of interests, defining quality and savings targets, creating a transparent collaboration between payers and providers, and pulling it all together with a cloud-based claims analytics tool. Read now or download and read later

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Two New Federal Interoperability Rules: What You Need To Know

Two New Federal Interoperability Rules: What You Need to Know

  • January 12, 2017

Federal agencies finalized two new rulings aimed at accelerating the pace of interoperability in health IT.  The ONC just released its 2017 Interoperability Standards Advisory and final rulings were made on MACRA. In the first of a series of white papers on interop policy, we review what these regulations mean for the industry. Taken together, the rulings demonstrate the government’s commitment to pushing the industry towards a fully open and connected health information infrastructure. Read now or download and read later  

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The State Of Value-Based Reimbursement And The Transition From Volume To Value In 2014

The State of Value-Based Reimbursement and the Transition from Volume to Value in 2014

  • January 1, 2017

How fast are payers and providers adopting new value-based payment models? According to the first industry study of its kind, more than two-thirds of payments are expected to be based on value measurements by 2020. Remarkably, 90% of payers and 81% of providers are already using some mix of value-based reimbursement and fee-for-service, according to the new report, The State of Value-Based Reimbursement and the Transition from Volume to Value in 2014. Read now or download and read later  

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Authorization Playing Catch Up With Technology

Authorization Playing Catch Up With Technology

  • January 1, 2017

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

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Five Strategies For Maintaining Healthy Revenue During An EMR Transition

Five Strategies for Maintaining Healthy Revenue During An EMR Transition

  • January 1, 2017

One of the biggest mistakes when transitioning to EMR is not treating clinical and financial systems as inseparable. That costs providers millions, even tens of millions, in revenue lost or delayed. Follow the five strategies in this white paper to ensure your organization's revenue doesn't take a big hit during your next EMR transition. Read now or download and read later

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Beware The EHR “Ripple Effect”

Beware the EHR “Ripple Effect”

  • January 1, 2017

When implementing new EHR systems, finance departments often see an increase in accounts receivable days and claim denials, and as a result, a dip in cash flow. This "ripple effect" is a potential pitfall when moving to a new EHR. This white paper documents five steps providers can take when gearing up for and implementing a new EHR system. Read now or download and read later

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