Topics: Contract Negotiation, Denial Management
In the dynamic landscape of healthcare, negotiating contracts with insurance payors is a critical skill for providers. These negotiations determine the reimbursement rates for services, which directly impact the financial health ...
Topics: Price Transparency
In recent years, the issue of hospital price transparency has gained significant attention in healthcare discussions worldwide. While the concept seems straightforward — providing patients with clear and accessible information ...
Topics: Revenue Cycle Management, Surgical Charge Structure
In the fast-paced environment of the operating room (OR), maintaining accuracy is not limited to medical procedures—it also extends to financial operations, particularly accurate billing or “charging” for procedures, supplies, ...
Topics: Revenue Cycle Management
Revenue Cycle Management (RCM) is a critical process in the healthcare industry, especially within hospitals. It encompasses the entire financial lifecycle of a patient’s interaction with a healthcare provider, from appointment ...
Topics: Contract Negotiation
In healthcare today, charges are increasing, reimbursement is tightening, and pricing has become available for the public. Charges must be simplistic and straightforward for consumers to understand. Headlines highlight patients ...
Topics: Revenue Cycle Management
A study summarized on yahoo!finance indicates that the future of Health Care Revenue Cycle Management may include increases in outsourcing. “The study, entitled PatientPay 2022, found 63% of respondents indicated they were ...
Topics: Revenue Cycle Management
Hospital margins depend highly on the type and volume of services they perform. Historically, the hospital was the only place to go for healthcare services. However, today a variety of stand-alone specialty locations can meet ...
Topics: Surgical Charge Structure
4 Key Elements to Establish Effective Surgical Charges Charge Setting in the Operating Room Perhaps one of the most enigmatic locations in the hospital for setting charges is the Operating Room (OR). The same procedure can vary ...
Topics: Contract Negotiation, Denial Management
According to Becker's Healthcare, as of Quarter 3 of 2022, "economists have classified 2022 as the worst financial year for hospitals in decades," as the profit gap between payer and provider continues to widen. Figure 1.1 Note. ...
Topics: Revenue Cycle Management
What it IS The patient-centric revenue cycle considers the patient's experience throughout the billing process. This includes an upfront understanding of the cost and transparent and timely communication regarding the balance due ...
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