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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant

Why Healthcare Marketers Should Care about the Patient Financial Experience

by Will Reilly, VP of Consumer and Client Marketing at VisitPay 10/23/2018 Leave a Comment

Hospital CFO_New Financing Program Minimizes Impact of ICD-10 Revenue Delay for Private Practices_revenue cycle management

What comes to mind when you think of health system marketing? For most people, it’s dynamic content on the organization’s latest clinical advancements, philanthropic efforts, wellness management and relationship-building efforts within the community it serves. It’s also understanding patients and their motivations, using consumer research and analysis, focus groups, surveys, and other tools.  You probably don’t think about the healthcare billing experience.It’s understandable. Frank discussions
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R1 Expands Physician Practice Footprint with CarePoint Health and Holston Medical Group

by Jasmine Pennic 10/22/2018 Leave a Comment

R1 RCM, End-to-End Revenue Cycle Management Services Phreesia Partner to Provide Seamless Front-End Patient Experience

Hatred of billing and payment processes is a time-honored tradition in healthcare. Two of the biggest reasons it’s so frustrating as a patient are the lack of transparency and digital elements that we expect out of any typical consumer experience. R1, a provider of technology-enabled revenue cycle management (RCM) services is working to change this, announcing today its continued expansion into the physician practice market with the addition of CarePoint Health, one of the largest privately-held
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Waystar Acquires UPMC’s Ovation Transaction Services Business for Enhanced Claims Monitoring Capabilities

by Fred Pennic 10/03/2018 Leave a Comment

Waystar Acquires UPMC’s Ovation Transaction Services Business for Enhanced Claims Monitoring Capabilities

Waystar(formerly known as ZirMed), a provider of healthcare revenue cycle management services, today announced it will be acquiring a major part of the transaction services technology business of Ovation, a health information management and management cycle solution currently owned and operated by University of Pittsburgh Medical Center (UPMC). Financial details of the acquisition were not disclosed.Ovation Transactions uses advanced algorithms to monitor claims at many health systems and
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Top 10 Challenges, Issues and Opportunities for Healthcare Executives in 2019

by Jasmine Pennic 09/28/2018 Leave a Comment

Top 10 Challenges, Issues and Opportunities for Healthcare Executives in 2019

After 2.5 days of thought leadership discussions during its 30th Anniversary Annual Forum, executive participants of the HealthCare Executive Group (HCEG) voted on and ranked the 2019 HCEG Top 10 critical challenges, issues and opportunities they expect to face in their organizations in the coming year. Background/MethodologyThe rankings were developed in partnership with Change Healthcare and have been published for the last seven years. Executives from the payer, provider, and technology
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Cedar Unveils Next Evolution of Patient Payment Platform to Optimize Revenue Cycle

by Fred Pennic 09/21/2018 Leave a Comment

Cedar Unveils Next Evolution of Patient Payment Platform to Optimize Revenue Cycle

Cedar, a patient payment and engagement platform, announced the next evolution of its flagship solution, Cedar Pay. The enhancements now allow providers to offer a truly unified patient billing experience and simple checkout options.Healthcare executives still struggle to help patients understand and pay healthcare bills, with 50 percent of provider executives reporting the need to improve the patient billing and payment experience, according to a recent Cedar study. The next evolution of
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Change Healthcare, Amazon Partner to Build Claims & Payment Network

by Fred Pennic 09/18/2018 Leave a Comment

Change Healthcare Acquires Credentialing Tech Docufill to Improve Administrative Efficiency

Change Healthcare, today announced that its Intelligent Healthcare Network will now be complemented with a cloud-based network built on Amazon Web Services (AWS). The new cloud-based network infrastructure to promote more efficient, transparent, and secure administrative and financial transactions.As the first stage of a collaborative initiative working with stakeholders across the healthcare ecosystem, the company will deploy this network on Amazon Web Services (AWS). The network will allow the
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Ciox Launches Learning Platform to Train/Assess Medical Coders

by Jasmine Pennic 09/18/2018 Leave a Comment

Health technology company Ciox, today launches a platform designed to train and assess medical coders, equipping coders with vital education and development opportunities in an academic setting or on the job. Named Ciox HealthSource Gym, it’s a SaaS platform that provides an engaging learning environment of data-rich training and practice scenarios to optimize coding performance.The module sits on top of Ciox’s HealthSource, a clinical data platform that uses the latest interoperability and
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RCM Provider Waystar Acquires Predictive Analytics Company Connance

by Fred Pennic 09/17/2018 Leave a Comment

RCM Provider Waystar Acquires Predictive Analytics Company Connance

Waystar, a revenue cycle technology company, today announced its acquisition of Connance, a provider of healthcare predictive analytics. As Waystar became one of the nation’s largest healthcare financial data sources through the merger of Navicure and ZirMed last year, this new acquisition will enable the company to bolster existing end-to-end revenue cycle technology offerings and predictive analytics capabilities to more than 450,000 providers, 22,000 healthcare organizations and 750 health
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Fellow Health Partners Acquires Medical Billing Company Physicians Management, Inc.

by Jasmine Pennic 09/11/2018 Leave a Comment

Fellow Health Partners Acquires Medical Billing Company Physicians Management, Inc.

Fellow Health Partners, Inc., a New York-based medical business solutions company, today announced its acquisition of Physicians Management, Inc., a long-established medical billing company based in Rochelle Park, New Jersey. Fellow Health Partners expects to continue its rapid growth by combining acquisition of well-respected medical billing companies with its superior technical and customer services for hospitals, medical practices, and ambulatory surgery centers.“Physicians Management has
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Optimizing Revenue Cycle Management – What Will It Take to Get There?

by Stacy Leidwinger, VP of Product, Nuance’s Document Imaging Division 09/04/2018 Leave a Comment

The U.S. healthcare system is undergoing a major transformation, from many freestanding hospitals and individual practices to fewer large, integrated healthcare systems. One motivating factor is the promise of greater efficiencies when it comes to delivering more holistic patient care and improving core operational processes. Revenue cycle management is one process that’s primed for improvement. Poor billing practices can cost hospitals millions of dollars due to lost reimbursement or the imposition of fines, which can undermine patient care quality and erode the operational advantages that expansions and mergers were intended to create. What are the ongoing trends making revenue cycle management so challenging? Disjointed front-end and back-end processes – Revenue cycle management is traditionally separated into front- and back-end functions. The front-end is patient-facing and includes administration, intake documents and the confirmation of coverage eligibility, while the back-end includes payer coordination, claims reimbursement, denial communications and ultimately, collection. With patients assuming more responsibility for out-of-pocket expenses, the first step to improving the revenue cycle is maximizing patient collections. The best chance for this lies in collecting payments as early as possible in the patient interaction. According to one recent survey, 85 percent of healthcare organizations say that collecting payments from patients after they have left the facility is a difficult task. Hospitals need to commence billing processes immediately at patient admission, which requires better integration between front- and back-end workflows. Electronic or digitally-based workflows are intrinsically more efficient and secure than paper-based workflows since they don’t rely on paper passing hands and because there is less risk of document misplacement. IT and Toolset Limitations – Successful revenue cycle management has traditionally depended on a strong supporting healthcare IT infrastructure as well as a solid base of highly fluent administrative knowledge workers, who understand the intricacies of working with various types of payers. Unfortunately, many hospitals do not have the resources to invest in the dedicated on-site infrastructure needed to expedite revenue collection and claims management. Hospitals should also train staff members to code and submit claims as accurately and efficiently as possible. The lack of training is often the difference between a fast, efficient claims reimbursement and a potentially time-consuming kick-back. It is also important for knowledge workers to have “DIY” capabilities when it comes to directly hand-picking their own workflow functions to secure the capabilities they need quickly. Back-end staff may include an electronic signature capability in their workflow, which allows supervisors to verify the authenticity of a claim and sign-off, even if they are traveling or on a mobile device. If software tool is available as part of a larger, pre-approved menu, this will also reduce the threat of “shadow IT” - when staff use technology without IT being aware. Lack of automation – Paper remains ubiquitous in the healthcare enterprise, particularly in the admissions process. Better revenue cycle management requires faster, more efficient digitization of paper-based documents. It is particularly important to quickly incorporate insurance details contained in these documents into streamlined digital workflows. Revenue cycle management can be made more efficient by automating manual data entry. Document conversion and classification can easily convert paper documents to digital form in bulk and route the data to appropriate electronic files and personnel for processing. Advances in machine learning soon will enable scanners to “read” and identify characteristics specific to certain documents. For example, the technology could identify an insurance policy, and route the information appropriately while streamlining the entire claims submission process. Poor provider/payer collaboration – Forward-thinking hospitals are creating new types of streamlined payment processes whose workflows are similar to those integrating front- and back-end claims processing. Tailored workflows can address the unique requirements of individual payers, enabling information exchange and critical communications through a highly secure, digital process. For example, different payers may use a different chain of command or steps for reimbursement approvals. Workflows can be created and modified to adhere to acknowledge this. These provider/payer frameworks also provide end-to-end visibility across the claim lifecycle, allowing providers to take appropriate action to improve collection processes – for instance, identifying and addressing late reimbursements. Increased automation plays a role here as well by alerting knowledge workers when a particular claim reimbursement is complete, or automatically flagging problems and their source. While the challenges of improving revenue cycle management are abundant, and many organizations aren’t sure where to begin, certain threads are common. These include the need for tighter workflow integration (both within an organization and between payers and providers) and greater empowerment of knowledge workers through automation and simplified workflows. Effective revenue cycle management is critical to the success of the healthcare enterprise in its mission to promote high standards of patient care and satisfaction and operational excellence. Most organizations have room for improvement, and the capabilities described here are a good starting point. Stacy Leidwinger, VP of Product, leads the team driving product innovation within Nuance’s Document Imaging Division. She oversees the product roadmap and all phases of the product lifecycle with the goal of planning, launching and managing best of breed software products.

The U.S. healthcare system is undergoing a major transformation, from many freestanding hospitals and individual practices to fewer large, integrated healthcare systems. One motivating factor is the promise of greater efficiencies when it comes to delivering more holistic patient care and improving core operational processes.Revenue cycle management is one process that’s primed for improvement. Poor billing practices can cost hospitals millions of dollars due to lost reimbursement or the
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