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Healthcare

6 Questions to Ask When Shopping for Revenue Cycle Management

And yes, the percentage is important, but the true cost of a solution can go much deeper. I see practices lose huge amounts of revenue because of not fully reworking claims denials, regulations are changing, and offshoring billing is no longer allowed in some jurisdictions.

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Healthcare

Capitation Reimbursement Models: Why They Are Growing in Popularity

Medical providers took a financial hit when the world shut down and fewer patients scheduled routine care and procedures. The New England Journal of Medicine evaluated one of the longest-running value-based care arrangements and found that: The American Medical Association says doctors aren’t “ethically required” to take on every patient.

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Healthcare

Appeals and Grievances: Data Driven Compliance…How Do We Get There?

Appeals and grievances departments work diligently to maintain compliance, keep up with regulations and serve members. However, with large caseloads and many moving parts, manual processes often open up potential risks. As a result, many are turning to data-driven compliance and process automation to mitigate that risk.

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