Claims Processing

By Mike Miliard 10:39 am January 20, 2015
Is your hospital ready for the impact of ICD-10 and bundled payments? Providers will need good RCM systems this year to "get every dime they are entitled to."
map and compass
By Mike Miliard 10:07 am January 05, 2015
Most providers' revenue cycle management technology is getting pretty long in the tooth, installed years ago to process the relatively simple transactions of volume-based care. As healthcare moves toward pay-for-performance, hospitals and practices will be investing in next-generation tools -- or outsourcing them.
By Henry Powderly 09:10 am November 26, 2014
More and more hospitals are turning to outsourced revenue cycle management services, especially as the challenging shift to value-based payment models leaves them realizing their own legacy systems are inadequate to the job. The market for end-to-end RCM outsourcing could reach $10 billion by 2016.
Calculator and spreadsheet
By Rodney J. Moore 09:56 am November 18, 2014
The collections process is ripe for innovation, on both the payer and provider side. Increasingly, savvy providers are using health IT to broaden their access to and knowledge about their patient populations, with an eye toward greater success with bill collection.
By Anthony Brino 09:41 am November 10, 2014
Just days after a new GOP majority swept into Congress vowing to limit if not repeal the Affordable Care Act, the Supreme Court, in a surprise decision, announced it would agree to hear a case on the one of the most audacious challenges to the ACA -- the argument that only state-based exchanges can have subsidies.
By Mike Miliard 10:52 am October 15, 2014
ABILITY Network, which develops workflow technology for hospitals, home health agencies and other care settings, will acquire MD On-Line, maker of electronic data interchange and revenue cycle tools for payers and providers, for an undisclosed sum.
By Mike Miliard 10:46 am September 30, 2014
Optum, the health IT division of UnitedHealth, will acquire MedSynergies -- which makes practice management, revenue cycle, physician referral management and other ambulatory-focused technology -- for an undisclosed sum.
Growing money
By Bernie Monegain 10:41 am August 27, 2014
A Mississippi health system and three hospitals in Texas, Indiana and Alabama are illustrating how hospitals can thrive, even in a tough economic environment. One hospital increased its revenue by $8.2 million after improving clinical documentation. Another changed the way it collected for services and boosted revenue by $6.1 million.
data code
By Erin McCann 10:23 pm August 08, 2014
By mining state Medicaid data and utilizing a population health platform, the Wyoming Department of Health was able to slash its Medicaid-related emergency room visits by 20 percent in a one-year period.
By Mike Miliard 10:24 pm August 01, 2014
The revised compliance date for providers, payers and clearinghouses to transition to ICD-10 has been finalized by the Department of Health and Human Services. It's Oct. 1, 2015 -- just 14 months from today.

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