Revenue Cycle Management
Healthcare providers rely on revenue cycle management (RCM) systems and processes to handle crucial financial functions, including invoice processing, claims management, reimbursement, accounting, payroll, insurance, compliance, and taxes. By helping patients navigate their payment obligations, RCM systems not only ease the administrative burden on providers but also improve the overall financial health of the organization. To know more, read our Revenue Cycle Management special issue.
Leveraging AI in Revenue Cycle Management for Healthcare
By Jennifer Wheeler, VP of Revenue Cycle, Stone Diagnostics The integration of Artificial Intelligence (AI), automation, and data analytics into the revenue cycle management (RCM) of healthcare facilities marks a transformative leap toward operational excellence. In an era where financial ...
The Power of Numbers and Dashboards: A Data-Driven Strategy for Optimizing Revenue Cycle Management
By Ahmad Kilani, Medical Director and Nicholas Libertin III, Enterprise Physician Advisor, Cleveland Clinic The rise of physician advisors has been a transformative development in 21st century healthcare. Many healthcare systems have adopted an enterprise physician advisor model to streamline ...
Clinicians and Revenue Cycle: Why the separation?
By William Gress, RN, MHA, BSN, CHFP, CRCR, Director, Revenue Cycle Operations, Cottage Health Healthcare is a business unlike any other. Many economists describe healthcare as an imperfect market, where the consumer is not the one paying for the goods ...
Navigating the Complexities of Denials and Appeals in Healthcare Revenue Cycle Management (RCM)
By Dr. Angela Comfort, MBA, RHIA, CDIP, CCS, CCS-P, AVP Revenue Integrity, Montefiore Medical Center The healthcare industry faces continuous challenges in maintaining efficient RCM, which is essential for the sustainability and operational success of healthcare providers. A particularly challenging ...
The Value of an Audit
By Kelly Lanning, Director of Revenue Analysis, Detroit Medical Center Healthcare relies on audits to ensure they remain compliant and assist with identifying potential risks. Is your organization prepared? Audits occur on many different levels and have different areas of focus ...
Navigating Revenue Cycle Challenges: Strategies and Solutions Implemented by Our Organization
By Mea Ford, System VP of Revenue Cycle, Renown Health Navigating revenue cycle challenges, from billing errors to insurance denials and patient collections, requires diligent effort and strategic approaches. Automation has proven invaluable in streamlining processes and reducing errors, supported ...
Too Many Walls and Not Enough Bridges: Bringing Together the Great Minds of Revenue Cycle and IT
By Beth Carlson, VP of Revenue Cycle, WVU Medicine One of the simple truths is that “none of us is as smart as all of us.” This rings especially true as IT and revenue cycle teams seek to establish a ...
A People-First Approach: Optimizing Reimbursement through Engaged Teams
By Lynn Ansley, VP RCM, Moffitt Cancer Center Aligning professional development and succession planning within revenue cycle management (RCM) begins with getting the right people on “the Bus.” This enhances operational efficiency and accuracy, increases team member engagement, and optimizes ...
Revenue Cycle: The Healthcare Delivery Experience Bookends
By Willie Brown, VP of Revenue Cycle, Sentara Healthcare During a recent leadership meeting with our CFO, we were reminded that as quiet as it is kept, an organization’s revenue cycle acts as bookends for the healthcare delivery experience. In ...
Transforming Revenue Cycle Efficiency Through Integrated Leadership
By Katy Ryan Michaud, VP of Revenue Cycle, Franciscan Missionaries of Our Lady Health System In the post-covid world, revenue cycle teams face unprecedented challenges and opportunities. The industry is evolving rapidly, requiring teams to adapt to changing regulations, technologies, ...
North American Partners in Anesthesia (NAPA): New value-driven MSO/RCM services offer hospitals innovative solutions
Health system economics are increasingly under pressure. Challenged by nationwide clinical staffing shortages, decreasing reimbursements from government and private payors, and the increased administrative burdens associated with a value-based care environment, hospitals are seeking new strategies and solutions to ensure ...
Revenue Boosting Strategies to Implement this New Year, 2024
By Anneleah Williams-Bridges MS, RHIA, CCS, CCS-P, CCDS, RH-CBS, ACDIS Leadership Council, AHIMA Approved ICD-10 Trainer Hospital executives and leadership are actively seeking ways to increase revenue flow and optimize their organization's bottom line. We will explore five essential revenue-boosting ...
The evolving role of automation in the transformation of healthcare revenue cycle
By Sheldon A Pink, President & CEO, Krystal Rock Innovation Group Automation is taking the healthcare industry by storm. Every organization is exploring opportunities to invest in Robotic Process Automation (RPA), Machine Learning (ML), or Artificial Intelligence (AI). Even though ...
Strategic Approach to Revenue Cycle Management (RCM)
By Karina Checo, Director of Revenue Cycle, Bergen New Bridge Medical Center The revenue cycle sector of healthcare has seen a dramatic evolution in roles over the last decade. Daily tasks have changed to accommodate regulatory, technological, and payer behavior ...
Navigating the Automation Maze: Revolutionizing Revenue Cycle Management (RCM)
By Kris Seymour, Director, Revenue Cycle Transformation and PMO, WellStar Health System In the ever-evolving healthcare landscape, RCM stands as a critical aspect that ensures financial stability for healthcare providers. However, the journey of optimizing revenue cycles is fraught with ...
Navigating the Medicaid Redetermination Maze
By Seth Jeremy Katz, VP of HIM and Revenue Cycle, Finance, University Health of Kansas City Medicaid serves as a vital lifeline for millions of Americans, offering essential support during health-related challenges. Despite its indispensable role, the program has often ...
Marshfield Clinic Health System’s Technology-Driven Revenue Cycle Optimization
By Surya Ravulaparthy, VP of Revenue Cycle, Marshfield Clinic Health System Health care providers continue to experience financial pressures due to various internal and external factors, like declining reimbursement rates, rising inflation, declining workforce availability and complex regulatory requirements. Marshfield ...
The Role of Automation in Revenue Cycle Operations and its Transformative impact on the healthcare industry
By Adrienne Moore, VP of Revenue Cycle, Banner Health I’m not sure whom to credit for the now universally accepted terminology to explain the technology adoption curve, but it does apply to automation. The innovators are the first out of ...
Recent Trends in Revenue Cycle Management
By Kimberly Corriveau, Director of Patient Financial Services, North Texas Medical Center After the 2022 financial healthcare struggle, many healthcare systems have faced the challenge of creating a profitable revenue cycle. According to Becker’s Healthcare, expenses increased while revenue growth ...
Transforming Revenue Cycle Management through Automation and AI
A Conversation with Navaneeth Nair, Chief Product Officer at Infinx Healthcare In the rapidly evolving world of healthcare finance, Infinx Healthcare is emerging as a key innovator, helping transform revenue cycle management (RCM) through cutting-edge automation and AI technologies. Infinx's ...
Revenue Cycle Automation – Not If, Not When, But Now
By J. Brett Tracy, VP of Revenue Cycle, Arkansas Heart Hospital and Randall Reasbeck, Director of Business Intelligence and Revenue Cycle Technology, Arkansas Heart Hospital Automation in the revenue cycle is no longer a futuristic concept but a present necessity ...
Don’t Sleep on this Revenue Cycle Metric
By Rosalyn Powers, VP RCM, Northwell Health In theory, managing accounts receivable (AR) is a straightforward business. Often this entails gauging the health of the aging, ensuring the timely follow-up of accounts, submitting quality appeals, or having a handle on ...
Do’s and Don’ts while adopting RCM
By Shannon Fernandez, VP of Billing Services, Yakima Valley Farm Workers Clinic You likely receive several vendor emails daily highlighting the latest products promising to increase cash and reduce revenue cycle FTEs. Sifting through the onslaught of vendor options can ...
A Beautiful MINED: An Intelligence Leveraged Roadmap for Next-Gen Revenue Cycle
By Jason Gottlieb, Director of Revenue Cycle Academy, NewYork-Presbyterian Hospital There can be 200 or more individual pieces of data submitted on every hospital claim. A small hospital will submit a few thousand claims per week. Over a year, more ...
Transforming Change: How Technology can Create Gains and Close Gaps
By Kris Seymour, Director, Revenue Cycle Transformation and PMO, WellStar Health System There has always been a link between healthcare and technology. At once not often spoken, is now undeniable. As technology advances, there are innovations in healthcare that are ...
Recent Trends and Roles of Emerging Technologies in Revenue Cycle Operations
By Sheldon A. Pink, VP of Revenue Cycle, Luminis Health The healthcare revenue cycle technology space has significantly evolved over the past five years. Before the pandemic, there were many companies striving for automation, integration, reporting, and workflow efficiency to ...
Revenue Cycle’s Impact on the Patient Experience
By Emily Goertz, VP of Revenue Cycle, UTMB Hospital margins are thin if any at all. After this last year with the ongoing pandemic, hospitals and health systems have seen an erosion in their operating margins. Unfortunately, outpatient volumes have ...
Collaborative Partnership Model for a Successful Revenue Cycle Automation Team
By Kristin Milano, AVP, IS Clinical Systems – Revenue Cycle and Finance, Ochsner Health We are all tasked to do more complex work as we face staff challenges across the healthcare industry. Our team at Ochsner Health has been working ...
The Future of the Revenue Cycle
By Kimberly Corriveau, Director of Revenue Cycle, Central Ohio Urology Group Healthcare revenue cycle is recovering from an extraordinary public health crisis and as the world changes to acclimate to these sudden changes, so are healthcare organizations. This COVID-19 ...
Systemization of RCM processes resulting from strategic inflection points
By Michael Kos, VP of Revenue Cycle, Memorial Health One of the leading healthcare organizations in IL, Memorial Health based in Springfield is a five-hospital, community-based, not-for-profit organization that provides a full range of inpatient, outpatient, home health, hospice, behavioral ...