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Financial/Revenue Cycle Management

A healthcare organization's revenue cycle is its financial circulatory system. Preventing denials of claims and maintaining a visible, efficient billing process are key parts of a healthy revenue cycle. However, very few organizations have a perfect revenue cycle process. "Without some critical changes to provider workflow and revenue cycle management practices, providers will, in coming years, spend even more time and money chasing patient receivables and dealing with increased levels of uncollectible patient responsibility dollars," says Ralph Bernstein, senior vice president of U.S. Bank Healthcare Payment Solutions.

RELATED STORIES:
Visibility key to efficient revenue cycle management
KLAS report places Perot, Deloitte at top for revenue cycle services

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ICD-10 inches closer to delay, ICD-11 in the wings
February 16, 2012 | Tom Sullivan
The case for leapfrogging ICD-10 and holding out for ICD-11 just got a lot more curious. And though it's not here yet, when ICD-11 is ready, it will be something ICD-10 cannot: A 21st Century classification system.
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CMS promise on ICD-10 stirs the pot
February 15, 2012 | Bernie Monegain
When acting CMS Administrator Marilyn Tavenner said Feb. 14 that CMS would take another look at the timeline for converting from the ICD-9 billing code set to ICD-10, she unleashed a barrage of response across the healthcare industry.
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Technology helps government recoup $4B in Medicare, Medicaid fraud
February 15, 2012 | Stephanie Bouchard
The efforts to curtail healthcare fraud have returned $4.1 billion to U.S. taxpayers in 2011, says a new report from the U.S. Department of Health and Human Services and the Department of Justice. The fraud-fighting techniques employed by the government are largely supported by new information technology.
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Healthcare technology stocks poised for modest growth
February 2, 2012 | Larry McClain, Contributing Writer
Healthcare technology stocks don't have the obvious roadblocks facing many other healthcare sectors in 2012, according to industry analysts who spoke to an audience of 600 at the Nashville Health Care Council on Feb. 1.
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Greenway set for IPO
February 1, 2012 | Mike Miliard
Facebook's expected IPO filing may be the talk of Wall Street this week, but electronic health record and practice management firm Greenway Medical Technologies is poised to make some waves of its own with an $80 million initial public offering set for Thursday.
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Blue KC goes for new master patient index
January 31, 2012 | Bernie Monegain
Blue Cross and Blue Shield of Kansas City will roll out a new enterprise master patient index that will enable the insurer to meet new demands for comprehensive, aggregated patient data in the health information exchange environment.
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Bipartisan Policy Center calls for more, better health IT
January 27, 2012 | Bernie Monegain
A think tank with a healthcare task force chaired by former Senators Tom Daschle, a Democrat, and Bill Frist, MD, a Republican, is advocating for improved and better-used health information technology. Among the group's recommendations is "robust" data exchange.
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Neupert to join Brailer's Health Evolution Partners
January 26, 2012 | Bernie Monegain
Former Microsoft Health Solutions Group executive Peter Neupert will join Health Evolution Partners, a venture capital firm launched by former National Coordinator for Health IT David Brailer, MD, as an operating partner.
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Buoyed by IT, small practice confidence is up
January 24, 2012 | Mike Miliard
Sixty percent of physicians in small or medium-sized practices say technology has made things easier for them, and nearly half say business is better this year compared to last, according to a new survey released today by EMR vendor Practice Fusion.


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UPMC puts tech to work on supply chain
January 24, 2012 | Bernie Monegain
UPMC aims to reduce supply chain costs by moving all electronic transactions with suppliers to an electronic data interchange (EDI).
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South Carolina employs IT to boost Medicaid for kids
January 23, 2012 | Mary Mosquera
South Carolina has received kudos for improving improving how it expands and retains eligible children in Medicaid by using information from other safety-net programs, such as food stamps. The technology is employs to share data have also led to greater efficiency and reduced state administrative costs.
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States put tech to work on Medicaid enrollment
January 19, 2012 | Mary Mosquera
More than half of states expanded and simplified their Medicaid and Children's Health Insurance Programs' eligibility, enrollment and renewal procedures in 2011, often using technology to streamline and automate processes.
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Case Study: Sentara Healthcare Completes an Award-Winning EHR with Enterprise Content Management
April 29, 2011 | On Demand Webinars
Providers today recognize that even the most powerful EMRs can't handle the content that exists outside of the patient record. Unstructured, ancillary documents and content related to patient care – paper, forms, faxes, graphics, photos and other clinical images – is often disconnected from electronic records. For Sentara Healthcare, access to accurate, timely and complete patient information is instrumental to increasing quality and service of care, and enterprise content management (ECM) is a vital part of that enterprise EHR strategy.
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Improve care quality, coordination, and revenue with Apixio Community Search
February 14, 2012 | On Demand Webinars
Studies show that more than 60% of key clinical patient information resides within narrative text or scanned documents, effectively hidden from care providers and mission-critical care or payment systems. Frequently, health care records are widely dispersed and duplicated across many data silos in multiple forms and structures. Therefore, it is becoming more difficult for healthcare systems to efficiently leverage patient data to meet specific patient and quality care objectives. With physician revenues increasingly tied to achieving quality or cost goals, it is critical to apply insights derived from analysis of clinical information. View this webinar to learn how using Apixio’s intelligent information mining and retrieval within clinical workflow tools, such as electronic health records, can effectively use the entire patient record to optimize care coordination, quality and safety, as well as provider revenue.
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GE Healthcare Case Study: New EDI services platform delivers high availability, scalability cost-effectively
February 1, 2012 | White Papers
GE Centricity EDI, part of GE Healthcare IT’s Centricity portfolio, leverages technology to help healthcare providers improve patient care, process claims more quickly and efficiently, streamline operations, trim revenue cycles, and improve cash flows. Processes that were once handled manually are automated and can be performed around the clock. And by managing processes with technology—such as verifying patient insurance eligibility—Centricity EDI frees administrative staff to perform tasks that are more valuable to patient care and satisfaction levels.
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Selecting the Right EHR for the Life of your Practice and Your Patients
February 1, 2012 | White Papers
If we are at or approaching a technological tipping point in the history of healthcare, then it has never been more important for physician practices to select the right electronic health record (EHR) – and there are tangible reasons to believe so.  This whitepaper comments on recent customer surveys, and discusses foundational criteria for selecting the right EHR solution, determining your “game plan” and the process for assessment and selection. Justin Barnes is chairman emeritus of the national Electronic Health Record Association (EHR Association), and is vice president of marketing, industry affairs and government affairs for Greenway Medical Technologies, Inc.
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Four EHR Change Management Mistakes - and how to avoid them
February 1, 2012 | White Papers
The question is no longer if your healthcare practice will make the transition to electronic health records (EHR), but when.  Careful planning and effective change management can help keep missteps – and the stress and costs that come with them – to a minimum.  This white paper presents strategies for avoiding common problems as you select technology, choose your implementation team, assign responsibilities and lay out the logistics. Carefully considering these issues up front will help you reduce risk, contain costs and minimize overall impact of change on your practice.  You’ll be able to spend your time and effort in the right places, so that you can get back to caring for patients with a successful EHR implementation that fits your practice.
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Successful EHR Change Management: Roles and responsibilities
February 1, 2012 | White Papers
There are many important factors to consider when rolling out an EHR implementation, and one of the most important is getting your people behind the change. This paper provides insight into where your staff may be in terms of resistance to or support for new EHR system, and walks you through the process of making sure they have tools, training and support to move through the transition successfully.
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Return on Investment in EHRs: Meaningful Use Is Only the Beginning
February 1, 2012 | White Papers
Meaningful Use is only the beginning: Efficiency and more appropriate coding bring savings and increase revenues.  This whitepaper discusses features and benefits of an EHR system, government incentives, sources for ROI (return on investment) as well as building the business case for EHR. WE also address areas of efficiency savings and reductions in “soft costs”, as well as a customer example who realized many of these benefits.  Download this whitepaper now for additional details.
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Making (the most) of Technology Transitions: EHR imperatives and opportunities in today's medical practice
February 1, 2012 | White Papers
Medical practices have been contemplating the prospect of moving from paper-based records to electronic health record (EHR) systems for decades. But relatively few have begun taking steps to make the transition – until now. This white paper examines the factors that have kept many medical practices from moving forward with EHR over the years and the factors that are prompting action today; explains some of the technological requirements of making the transition to EHR and how to begin to meet them; and explores the significant operational, clinical and administrative benefits to be gained in the process.
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Providers' Perceptions: Business Intelligence and Analytics in Healthcare
January 19, 2012 | On Demand Webinars
Billian's HealthDATA and Porter Research will present findings of a primary market research study highlighting providers' perceptions of business intelligence and analytics solutions - their needs, challenges and adoption strategies. The study explores technologies being utilized today; as well as providers' requirements for the future that will better enable their organizations to drive strategic initiatives to improve quality of care, contain costs and meet impending and evolving healthcare reform initiatives.
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Accessing Medical Records on Mobile Devices
November 28, 2011 | White Papers
The emergence of a new class of Android (TM) mobile devices creates an opportunity for doctors and medical professionals to access patient data wherever they are. Read this white paper to learn how to access patient data and view medical images on Android devices.
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Transformational Strategies for Supporting EMR Adoption: IDC and Lahey Clinic Speak Out
November 22, 2011 | On Demand Webinars
EMR conversion is inevitable. The impacts to your workflow and efficiencies in care delivery remain serious obstacles to successful EMR adoption. Effective strategies during EMR implementation can lessen the blow and drive adoption during periods of transition. Participants will learn about: •Lahey Clinic's experience with successful EMR adoption •IDC's prescription for getting near term value today, while creating a sustainable approach for the long term •How to close the gap between traditional records and the EMR
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EMR and Quality Management: Best Practices
September 6, 2011 | On Demand Webinars
No doubt there's a learning curve when a practice firsts adopts and implements an EMR, just like any other type of transformational technology. But once providers get over that initial implementation hump, they can start seeing value not only at the time of care, but on many harder-to-manage aspects of how they care for patients.
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Telemedicine is on the rise
January 3, 2012 | James Ellis and Aaron Razavi
As a progressive new form of quality and convenient health, telehealth practices are growing, especially in rural areas, as it improves quality, access and cost of care. However, with a reimbursement model not clearly defined, some physicians are still reluctant.
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The Time is Ripe for Healthcare IT Start Ups (Part 2)
December 16, 2011 | Jennifer Dennard
In this week's edition, I continue my conversation with Sean Duffy, CEO and co-founder of Omada Health, a start-up out of San Francisco focused on prediabetes prevention via online tools.
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Maybe meaningful use won't mean meaningful savings
December 6, 2011 | Carl Natale
HealthLeaders Media has one of the more interesting reports available.
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3 Ways Satellite Emergency Departments Promote Hospitals and Health Systems
October 17, 2011 | James Ellis and Aaron Razavi
With uncompensated care, low Medicare and Medicaid reimbursements and incredibly large overhead costs, emergency departments (EDs) are one of the costliest sectors of a hospital.
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Healthcare IT Entrepreneurs Think Outside the Financing Box
October 11, 2011 | Jennifer Dennard
Big ideas are often hampered by small budgets. In the world of healthcare, the drawing board is often littered with cast-away notes for projects that never saw the light of day due to lack of funding.
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The five rights of staffing: Maximizing the clinical and financial benefits of an acuity system
August 23, 2011 | Nancy Barton, MSN, RN, and Heather Wood, MBA, RN
Hospitals and health systems often purchase acuity systems as a valuable tool to allocate nursing resources based on patient care needs. However, these organizations don’t always use their acuity systems to their full capability.
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Increasing Hospital Efficiency - The Growing Value of Mid-Level Providers
June 27, 2011 | James Ellis and Aaron Razavi
Mid-level providers, commonly called registered nurses (RNs) or physicians’ assistants (PAs) are a beacon of hope for struggling hospitals as the physician attrition rate and the number of aging Americans continues to spiral upwards.
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Lost in Translation? Clinical Decision Making and the Need for Lab Data Standards
June 7, 2011 | Gai Elhanan, MD, MA
The HITECH initiative and the promise of effectively coordinated care are fundamentally based on the adoption of standards as an integral part of the larger adoption of healthcare information technology.
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Don't let customized applications snarl cash flow during ICD-10 conversion
March 1, 2011 | Scott Kelly
Most healthcare organizations have modified or customized their billing applications. While these customizations are fine for their intended purposes, they pose rather large obstacles to the ICD-10 code conversion process.
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7 tactics for making ICD-10 urgent
February 9, 2011 | Tom Sullivan
What with meaningful use, EHRs, HIPAA 5010, and countless other healthcare projects, ICD-10 is on the backburner at many organizations. Yet, the deadline is approaching, achieving compliance is more complex than it may appear and the time is here to move ICD-10 up that priority list.
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2011 Predictions: MU Goes Tactical, ACO Strategic
February 3, 2011 | John Moore
As we move into 2011, we will continue to see an extreme amount of activity and turmoil in the HIT market with the biggest elephant in the room being what will actually happen to the healthcare reform bill that was passed at the beginning of 2010.
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Top 5 ICD-10 cost-savings categories
December 17, 2010 | Tom Sullivan
Given that ICD-10 compliance day is still nearly three years from now, most of the chatter about a total industry-wide sum for new code sets has leaned toward projecting an overall cost. But there's a flip-side: the cost-savings that converting to ICD-10 will bring the healthcare realm – and to the tune of billions of dollars.
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BlueCross BlueShield Venture Partners Joins $70 Million Private Investment Round in Essence Group, the Parent of Lumeris Corporation
October 27, 2011 | Industry News Release
Essence Group Holdings Corporation (EGHC) today announced that BlueCross BlueShield Venture Partners, managed by Sandbox Industries, has joined Kleiner Perkins Caufield & Byers and Camden Partners in a private investment in Essence.
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H.I.M. ON CALL answers hospitals' finance needs for stronger DNFB management with AVIANCEHealth™
September 30, 2011 | Industry News Release
H.I.M. ON CALL, a technology and outsourcing services company for health information management (HIM), coding and revenue cycle, announced the availability of its latest AVIANCEHealth™ technology solution, AVIANCE DNFB Management today at the American Health Information Management Association (AHIMA) Convention and Exhibit at the Salt Palace Convention Center in Salt Lake City, Utah. The announcement was made by Joseph J. Gurrieri, RHIA, CHP, Vice President and COO.
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Rural Mississippi hospital to deploy NextGen tech
August 23, 2011 | Industry News Release
NextGen Healthcare Information Systems announced today that Montfort Jones Memorial Hospital (MJMH) has selected NextGen(R) Inpatient Clinicals and NextGen(R) Inpatient Financials as key components of its transition to an automated healthcare information technology platform.
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Zynx Health launches new decision support services
August 9, 2011 | Industry News Release
Zynx Health, the market leader in providing evidence-based and experience-based clinical decision support (CDS) solutions, today announced the launch of ZynxValue+, a portfolio of services that identifies measurable gaps in hospital and healthcare organizations’ CDS, and recommends potential improvements in clinical content and processes.
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Anthelio Partners with Network of Critical Access Hospitals in Nevada
July 12, 2011 | Industry News Release
Anthelio, the leading independent provider of comprehensive healthcare information technology (IT) services and business process solutions for hospitals and other healthcare providers, today announced a partnership with Nevada Rural Hospital Partners (NRHP), an alliance of 14 rural hospitals in Nevada, including 12 critical access hospitals.
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CMS to pay $2.3M for help reducing hospital readmissions
June 28, 2011 | Industry News Release
The Centers for Medicare & Medicaid Services has selected The Lewin Group to help reduce the number of hospital readmissions for Medicare beneficiaries, and improve quality and outcomes when patients transition from hospitals to other settings, such as their homes or long-term care facilities.
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Optum Insight, InstaMed launch CareTracker Payment Connect
June 20, 2011 | Industry News Release
OptumInsight (formerly Ingenix) has collaborated with InstaMed, the leading Healthcare Payments Network, to offer CareTracker Payment Connect, a new feature for the CareTracker practice management system from OptumInsight, to help physicians give their patients more options to pay their bills electronically, and reduce administrative costs.
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23 percent of U.S. hospitals to invest in patient access solutions for eligibility
June 15, 2011 | Industry News Release
CapSite announces the release of the 2011 U.S. Patient Access Study. The study represents the latest in a series of CapSite strategic industry reports focused on the Revenue Cycle Management (RCM) market.
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New ACO at work in Tucson
June 9, 2011 | Industry News Release
Tucson Medical Center and local physicians, with the help of health technology and services company Optum, today announced they are creating the nation’s first “Sustainable Health Community,” based on an Accountable Care Organization (ACO) model in which hospitals, physicians, residents, employers and others share in the risk and rewards of making the health system work better for everyone.
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University of Iowa Health Care joins national effort to improve care
June 2, 2011 | Industry News Release
University of Iowa Health Care leaders announced today that the state's only comprehensive academic medical center has joined the High Value Healthcare Collaborative ( HVHC ), a national effort by leading health care systems to improve care, lower costs and move best practices out to the national provider community.
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Michigan health system joins quality collaborative
June 2, 2011 | Industry News Release
Beaumont Health System has been selected to join a prestigious national collaborative of health systems designed to improve health care quality, lower costs and expand best care practices to other health providers.
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Doc pay accounts for 8 percent of healthcare costs
June 1, 2011 | Industry News Release
Physician compensation accounts for roughly 8 percent of the total annual healthcare costs in the U.S., according to Jackson Healthcare, an Atlanta-based healthcare staffing and technology company.
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