Medcom Solutions Blog

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January 23, 2023

Are Your Payers Covering the New Cost of Healthcare?

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. ...

October 4, 2022

What is Revenue Cycle Management?

Topics: Revenue Cycle Management, Denial Management

All care provided within a health care institution has a cost and associated fee or payment. Managing the charging for and collection of such bills fall under the purview of the revenue cycle management team. The Healthcare ...

August 31, 2022

What are the differences between 835 and 837 and why knowing matters

Topics: Revenue Cycle Management, Denial Management

How do you know your services and procedures are paid accurately according to payor contract terms? Month after month, the question of net revenue and write-offs comes from the C-suite to the billing office and impacts all ...

May 17, 2022

PAYOR CONTRACT ANALYSIS AND NEGOTIATION: LEVERAGING THE INFORMATION AT YOUR FINGERTIPS

Topics: Contract Negotiation, Denial Management

PRICE TRANSPARENCY AND 835 PAYMENT DATA Have you evaluated your third-party payor contracts lately? Do you have any contracts coming up on renewal? Have you compared payments across payors for consistency and adequacy relative to ...

April 29, 2022

Using 835 & 837 Transactions Sets for Healthcare Claims and Remittance

Topics: Denial Management

The 835 and 837 transaction sets are two electronic documents vital to healthcare and commissioned by HIPAA 5010 requirements. They are an essential part of the hospital payment process, but one might not fully understand exactly ...