Revenue cycle compliance is a dynamic organizational issue that carries significant downside risk and requires a high level of managerial commitment to remain consistent in its achievement.
As patients become more responsible for their care, organizations that recognize the overlap between convenience and collections stand to improve both.
Revenue cycle performance is a strategic differentiator for organizations because it funds important functions and goals, including provider compensation and growth. With that in mind, creating a well-functioning revenue cycle requires organizations to focus on the three Ps: people, process, and platform.
Managing a revenue cycle has never been the most glamorous component of running a healthcare organization. Preregistering patients, collecting co-payments, submitting claims, and ultimately obtaining reimbursement for services is a costly and cumbersome process. It's also an essential one, since this is how healthcare providers are paid for the work they do.
By developing an integrated revenue cycle, a health system can reduce costs and improve financial performance in a way that equally meets the needs of its hospital and physician constituents.
Both employer- and individual-sponsored health insurance plans are mitigating the rising healthcare costs by passing them on to consumers, which is making patients more financially responsible for their healthcare utilization than ever before.
One often overlooked but potentially critical step in the preparation for the now delayed April 2015 transition from ICD-9 to ICD-10 is updating agreements between providers and payors.
Key considerations that organizations must address to reach an optimal end state in a value-based world.
Without a plan to implement ICD-10, you are at risk for lower revenue and higher costs. This article provides a framework to plan your transition to ICD-10 and discusses specific steps to mitigate the impact.
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