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Revenue Cycle

healthcare provider revenue ecosystem

It’s Time for Patient Care Leaders to Rethink Revenue Cycle

April 20, 2017

Last month, Kevin Ormand, Thomas Kiseau, Todd M. Bankhead, and Catharine Wilder of The Chartis Group published a white paper entitled “The Next Strategic Imperative: Rethinking Revenue Cycle Transformation.” It looks at the dramatic changes taking place around payment and operations in U.S. healthcare, and how those changes are impacting revenue cycle management. The white paper’s authors focus…

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3 Steps to Optimize the Revenue Cycle: from Transition to Transformation

June 11, 2014

Now that ICD-10 is delayed until October 1, 2015, according to the CMS (Centers for Medicare & Medicaid Services), healthcare providers who spent millions on training and preparation now must defer the ROI benefits for another 1-2 years. So where can providers see immediate financial benefits as payments transition from paper to electronic? Look to the Revenue Cycle!

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New EFT & ACH Standards Will Streamline Payments, Create Reconciliation Problems

June 10, 2014

Established in 1996, HIPAA standards addressing major transaction types in the revenue cycle were not enough to achieve industry Administrative Simplification. Currently, less than one-half of medical claim reimbursements are made electronically. The Affordable Care Act (ACA) is pushing for transformation by implementing compliance initiatives including the mandated 5010 and Healthcare Operating Rules for EFT & ERA. These are driven by CAQH-CORE (The Council for Affordable Quality Healthcare – Committee on Operating Rules for Information Exchange).

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Role of Banks in Automating Healthcare Payments

April 11, 2014

Former Health and Human Services Secretary and Governor of Wisconsin, Tommy Thompson is interviewed by healthcare payments expert, Mark Brousseau, President of Brousseau & Associates in Q&A Session #10. Gov. Thompson talks about the role of banks in automating healthcare payments. Healthcare expenditures are 20% of the GDP, so banks should want to lead the industry in order to maximize the revenue opportunities.

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Adding Value to Practice Management Systems

March 28, 2014

Practice management (PMS) software runs the business side of healthcare, from scheduling patients to billing to generating monthly reports. Unlike with electronic health records (EHRs), selecting and overseeing a PM system isn’t typically the physician’s domain. In a large practice, it typically falls on the office manager’s or IT manager’s shoulders.

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Healthcare Industry Pain Points Video

February 7, 2014

Former Health and Human Services Secretary and Governor of Wisconsin, Tommy Thompson is interviewed by healthcare payments expert, Mark Brousseau, President of Brousseau & Associates in Q&A Session #7. There are many pain points in the healthcare industry today. Many of them are due to the uncertainties of the future, which are tied to a general confusion on the implications of new regulations. Healthcare providers, payers and other players are all affected.

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HFMA – ANI 2013 to Play Critical Role for Healthcare Providers

June 14, 2013

The HFMA conference brochure pretty much tells it all, “What Now?” The healthcare industry continues to evolve and converge around several critical pieces of legislation including ACA, EFT/ERA electronification and ICD-10. HFMA sessions look very interesting as they address many revenue related topics!

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Chug, Chug… Here comes ICD-10. How will it affect Revenue Cycle Management and Receivables?

June 14, 2013

It’s a tough world out there for healthcare providers who are typically scrounging for 15-20% of their claims revenues which are either denied or incorrectly processed. ICD-10 is slowly approaching (10-1-2014), and with the number of codes jumping to 68,000 from the mere 14,000 of ICD-9, it made me wonder how much more difficult the billing and reconciling process may become for providers and patients as there are significant risks in this new process. Anne Smith, RN, principal and CEO of Fredrikson Healthcare Consulting, said, “while the biggest changes focus on code structure and conventions, it would be a mistake to assume only coders need training for the new system.“

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Weighing Pros and Cons of 3rd Party Billers in the Revenue Cycle

December 21, 2012

Third-party medical billing companies employ nearly 20,000 people nationwide and process more than 17 million claims per month, representing more than $18 billion per year, according to statistics provided by the Healthcare Billing & Management Association (HBMA), a trade association representing third-party medical billers.

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