Category: RCM

Insurance claim denials are a costly and time-consuming burden on every hospital and health system. But you can avoid most denials by taking the proper steps. Avoiding the most common types of denials — duplicate claims, medical documentation, timely filing, etc.…

Claims denials pose a serious issue for hospitals amid an already complicated reimbursement landscape. "Denials are a huge obstacle to timely and complete reimbursement," said Carmen Sessoms, associate vice president of the revenue cycle management advisory services program at Nashville,…

Average claim denial rates are between 6% and 13%, but some hospitals are nearing a “danger zone” after COVID-19, a survey shows. Hospital claim denial rates are at an all-time high, signaling a need for better claims denial management, a…

Tackling the causes of claim denials from the front end can help healthcare organizations reduce denials and increase the success rate of claims appeals.Despite changes in payment methodologies, claim denials cause sizeable revenue leakage for healthcare providers across the United…

Innovation is a necessity to any industry and RCM Healthcare is no different. Some of the new trends adopted by Healthcare providers from 2018 are Incorporation of AI into Medical billing, Shift to value-based healthcare, EHR Alignment, etc. Since then,…

CHALLENGES IN RCM INDUSTRYAs more hospitals and health systems have invested in automation for revenue cycle operations, it has become clear that the type of automation matters. Organizations have discovered that it can take up to 12+ months to build…

Social Security Disability Insurance (SSD or SSDI) is a payroll tax-funded federal insurance program of the United States government. It is managed by the Social Security Administration and designed to provide monthly benefits to people who have a medically determinable disability (physical or mental) that restricts their ability to be employed.  SSDI does…

Revenue cycle analytics helps to find a solution with cross-functional visibility to support decision-making. Diagnose problems, benchmark your performance with peers and prioritize opportunities that impact financial outcomes, patient outcomes, and staff productivity. Increase your clean claim rate to help…

Denial Management – Need of the hourWith leading hospitals and health care systems depending heavily on the revenue generated through insurance companies, it is to be noted that health insurers reject one out of five insurance claims in the US.When…

Virtual Healthcare and RCM Virtual healthcare refers to online/virtual meetings that take place between patients and clinicians via technology — the video and audio connectivity that allows “virtual” meetings to occur in real-time from virtually any location. A virtual meeting can…