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Blog Posts by Tag: Revenue Cycle Management

Five Steps to Capture Lost Revenue for Hospital Outreach and Outpatient Services | Part 2: Enhance Denial Management Capabilities

This blog post is part two of a five part series. View Part One. View Part Three. Part one of this series explored the adverse topline and bottom-line impacts of using an EHR system to manage outreach and outpatient services billing. We learned how the front-end automation functionality of a purpose-built revenue cycle management (RCM) system, used in concert with an EHR platform, mitigates these...

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On the Road to Herd Immunity, Labs and Payors Navigate Reimbursement Hurdles

Will I get paid for this? That’s not a question anyone wants to be posing when it comes to their work. Yet for most of 2020, amid the pandemic, it was one of the most pervasive questions from diagnostic laboratories to payors. While COVID-19 diagnostic testing volumes fluctuated dramatically, laboratories faced uncertainty in getting reimbursed for processing these tests. Then, in January 2021,...

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Five Steps to Capture Lost Revenue for Hospital Outreach and Outpatient Services | Part 1: Automate Front-End Processes

This blog post is part one of a five part series. View Part Two. View Part Three. Health systems and hospital groups are looking to outreach, outpatient, and ancillary services to boost topline and bottom-line results and bolster overall quality of care. Yet many of these departments are confined to using EHR systems designed for inpatient services. Too often, this leads to coding discrepancies,...

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The Remaining 20%: How Payor Policies and Specific Language Increase Success Rates of Appeals (Part 3)

This blog post is part three of the series. View part one. View part two. As we’ve covered statistically where our greatest challenges and opportunities lie, it’s important to recognize the appeal process is NOT a one-size-fits-all solution. Lesson 1: Report Documentation — “If it isn’t documented, it wasn’t billable” Appeals...

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After Large Spikes in 2020, Diagnostic Laboratory Testing Volumes on the Decline

As XIFIN CEO Lâle White wrote in her recent LinkedIn article, the COVID-19 pandemic created many challenges for the diagnostic industry in 2020. In the preceding years, many laboratories were running lean with little excess capacity. With the surge in COVID-19 testing demand, labs had to quickly add capacity to handle the new testing volume. In addition, dynamic regulatory changes designed to...

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How an Accurate Patient Out-of-Pocket Expense Estimator Helps Prevent Surprise Billing

There has been a lot written about surprise billing lately and the No Surprises Act, which includes surprise billing legislation, was signed into law the final week of 2020 and is slated to go into effect on Jan. 1, 2022. Surprise medical bills are unexpected balances the patient owes. This can occur for example when a patient receives care from a hospital that is in-network but is seen by a...

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5 Strategies to Boost Your Revenue Cycle Profitability

In some hospital areas, such as outpatient, outreach, and ancillary service centers, revenue and profitability suffers when relying on electronic medical records (EMR) systems and enterprise RCM processes.Why? Using existing EMR technology when handling RCM activity associated with all claims can lead to high-volume, low-value claims being uncollected. Many finance executives see this method as...

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The Remaining 20%: The Critical Role Appeals Play in Profitability (Part 2)

This blog post is part two of the series. View Part One. View Part Two. The first installment of this three part series provides data on denial trends in the pathology, molecular, and the clinical laboratory marketplace. Understanding root causes for specific denials enables us to initiate a strategic, multi-tiered approach to appeals. Measuring outcomes on all attempts to recover revenue,...

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