Blog Posts by Tag: Business Intelligence
How the Most Successful Laboratories in the Country Continue to Thrive in the Midst of an Increasingly Complex Reimbursement Environment
The business of laboratory revenue cycle management (RCM) becomes more complex every day; with reductions in reimbursement, increasing rejections and denials, payor specific billing rules, shifting financial reporting and accounting requirements (PAMA, FASB ASC 606, medical economics reporting), OIG and EKRA (false claims) compliance standards, malware and ransomware attacks, etc. Once there was...
Hidden Landmines in Revenue Cycle Management: 4 Rules of Report Analysis to Follow (Part 3)
This is the third post of a three-part blog series focused on key areas of business performance management for pathology practices, diagnostic laboratories, and molecular diagnostic providers. The other blog posts in this series can be found here: Part 1 and Part 2 At the recent Executive War College, I had the honor of presenting with Diana Richard and...
Hidden Landmines in Revenue Cycle Management: Misleading Metrics (Part 2)
This is the second post of a three-part blog series focused on key areas of business performance management for pathology practices, diagnostic laboratories, and molecular diagnostic providers. The other blog posts in this series can be found here: Part 1 and Part 3 Below, we have detailed the need for a complete understanding of the drivers behind the metrics...
Business Intelligence – Why EHR Revenue Cycle Modules Aren’t Enough for Hospital Labs (Part 4)
As the final installment of this 4-part series, we’ll review the remaining two considerations for hospital and health system lab leaders when it comes to selecting the right RCM system for outreach and outpatient laboratory services. As discussed earlier in this series, too often health system leaders expect outreach laboratories to use the hospital’s enterprise revenue cycle management (RCM...
Leveraging the Transformation of the CIO
The role of the CIO is changing. One of the ways in which this change is evident in the healthcare industry is through the transformation of the technology purchasing process. According to Gartner, CIOs going forward will be more deeply involved in differentiating technology and managing the flow of information in the context of customer interactions to foster better engagement.1 This can...
Data Quality Is a Cornerstone to Effective Revenue Cycle Management
One of the most challenging obstacles to diagnostic providers getting paid on time for their services is a lack of accurate patient data. Many laboratories struggle with the quality of the data that they receive and because they often lack direct access to the patients, it can be an expensive, manual process for lab team members to chase down incomplete, incorrect, or missing data that is...
A Conduit for Real-Time Lab Data Exchange
For labs looking for a conduit that allows for the pre-scrubbing of claims to ensure the likelihood of acceptance from the patient’s insurance provider, web services are the answer (Generically, a web service is any standardized software system designed to communicate with another system over the web; here, I will be referring to a specific set of web services created for the healthcare industry...