Why Specialized RCM Solutions in Healthcare is must now

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RCM

Revenue Cycle Management solutions help the medical services with the crucial tasks of processing claims and payments along with the services of effective management of the revenue cycle. These providers ensure streamlined cash flow and workflow in the health care industry by keeping in touch with the patients’ insurance reimbursement status and by checking their …

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Doctor to see higher payments reduced paperwork under 2020 Physicians fee schedule

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Doctor To See Higher Payments Reduced

CMS Fee Schedule for the physicians was issued on 1st November 2019 to be used for availing health services from 1st January 2020 onwards. This schedule served as an incentive for primary care physicians who used to avoid providing primary level services due to excess burnout and heavy paperwork. This schedule curtailed the need for …

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Healthcare Trends that will rock Medical Care in the 2020s

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Healthcare trends that will rock medical care in the 2020s

2020 marks the advent of the new decade and this new decade comes with new technological innovations and new challenges. With every field stepping up with advanced technology, medical and healthcare services are evolving and revolutionizing at the same pace. The inventions and innovations that were once seen only in high-tech and Sci-Fi movies are …

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Top 10 Challenges Physicians are Expected to face in 2020

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Top 10 Challenges Physicians Are Expected to Face in 2020

The new decade has come with new challenges accompanied by some other problems that left unresolved during the last decade. 2020 came with some unprecedented and unpredictable predicaments such as a global medical emergency due to the covid-19 outbreak making its way from China to the US in a few days. It increased the burden …

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Healthcare Data Breaches Affected 40 Million Americans in 2019

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Healthcare Data Breaches Affected 40 Million Americans in 2019

Healthcare data breaches are affecting millions in the United States and one of the major causes is hacking by cybercriminals. According to a report titled The State of Cybersecurity in Healthcare, by The Fortified Health Security which gathered data spanning over a decade and found that forty million Americans were affected in 2019. This is the …

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The Top Challenges That Independent Practices Are Facing In 2020

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The Top Challenges That Independent Practices Are Facing In 2020

Independent practices make up a major part of the American healthcare system. Undoubtedly, people are more influenced by these independent practices as they are relatively inexpensive and ensure better care than larger healthcare organizations and hospitals. Moreover, these practices have won patients’ trust by adding to their convenience as they provide low-beneficiary costs and are …

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Seven Tips of Effective Contract Negotiation For Physician Practices

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7 Tips of Effective Contract Negotiation For Physician Practices

Physicians go through a tough phase where they have to choose between opting independent practice and joining hospitals or other healthcare organizations. This decision proves to be a turning point in their medical career, so they have to weigh the pros and cons of each before taking a final decision. After a thorough cost-benefit analysis …

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Reasons To Outsource Your Revenue Cycle Management

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Revenue cycle management (RCM) in the healthcare industry has become the most sought-after thing. As healthcare providers are fraught with unpaid bills, payment denials, billing errors, ever-changing requirements, revenue leakage, and the inability to reform the financial cycle. According to a study 'the revenue cycle management market is projected to reach US$ 216,990.6 million in the coming few years. The RCM solutions are in huge demand in the healthcare sector due to its immense impact and value that it brings to the healthcare organizations. The healthcare industry has been drastically challenged by an increased cost of the services, decreased revenues and the system shifting to patient consumerism. This is putting huge stress on the care providers as they are struggling to implement new technologies, revamped infrastructure and focusing on improving the patient experience. More than 70 percent of patients are frustrated with the current billing system and they are not able to understand the complexities of the system. Surprising billing or out-of-network payments are some of the issues that are troubling patients or healthcare consumers. At the same time, the inability to pay is adding to the dilemma, when over 137 million Americans are struggling with medical debt. This is causing unrest among healthcare consumers and they are more concerned about the expected bill and the explanation of benefits. As the healthcare providers are transforming their processes to deliver value-based care, it has become immensely important to implement an RCM system that can bring transparency to their processes with technology-intensive RCM automation tools and capabilities to accurately report financial data. During these heightened financial stress, healthcare providers want their RCM processes are optimized, efficient and productive. The RCM system must be capable of meeting regulatory requirements as well. To meet all these requirements, healthcare providers seek services from professional RCM solution providers. RCM comprises a set of frond desk and back-end processes which includes administrative tasks as well as clinical functions. Some healthcare providers only choose to outsource a limited range of tasks, such as medical billing and coding, claim submission and payment follow-ups; while others move on to outsource IT administration and transcription as well. However, the decision to outsource depends on the capability of the healthcare facility to manage the resources. Here are a few reasons to outsource your revenue cycle management: To increase profitability: The first and the most important reason for outsourcing revenue cycle management is that healthcare providers want to improve their profitability. RCM vendors are experts in boosting the revenue collection process and have onboard specialized resources that can achieve it in a short while. Moreover, administrative costs, operational expenses, salaries, and rents have decreased the overall revenue of the providers. Outsourcing not only saves cost and time but also increases profits. Decrease administrative burden: When the RCM is outsourced to a trusted company, the healthcare provider can free up the resources from the administrative tasks. Providers can utilize these free resources to uplift their service standards. RCM is a complex process and engages the resources of a provider at various levels. If you are managing revenue cycle in-house then you are handling many administrative tasks manually, such as: • Paper-based record of payments and transactions • The manual patient registration process • Claim preparation and charge entry • Account receivable and payment follow-ups • Payment posting • Denial management and appeals The administrative burden would affect your performance. For instance, if your managing RCM in-house: • Your staff would be making lots of billing and coding errors • There would be delays in claim preparation and submission • Your staff won't be making targeted collections • There would be lags in denial management • Lack of financial insights and reporting Outsourcing RCM would set you free from all these administrative tasks that are consuming time and energies. Easy compliance to standards: Outsourcing makes compliance with industry standards easier. Healthcare is a volatile sector and ever-evolving regulations make it difficult to comply with. Either it is the adoption of new ICD codes, HIPAA compliance or conformity with insurance requirements; outsourcing makes it easier to embrace the change. By outsourcing it becomes the job of your outsourced RCM partner to stay updated and keep your system in compliance with the updated standards. If you are handling RCM in-house, it would indulge you in the up-gradation of resources and providing adequate training to your staff. Outsourcing sets you free from the hassle of training and compliance. However, there are various concerns of vulnerability to private data when you are outsourcing and providers remain concerned over the hidden charges. Some RCM vendors use software that does not integrate with the pre-loaded software applications of the provider. This is why a healthcare provider must carefully choose the RCM solution provider and must make these queries upfront. There is no doubt that by choosing the right RCM partner, you can not only save costs and time but can also increase your profitability. Revenue cycle management is becoming refined and more sophisticated and is helping healthcare organizations eliminate errors in their system, minimize complexity, increase in productivity and profitability. This is why healthcare providers must outsource RCM to a trusted partner.

Revenue cycle management (RCM) in the healthcare industry has become the most sought-after thing. As healthcare providers are fraught with unpaid bills, payment denials, billing errors, ever-changing requirements, revenue leakage, and the inability to reform the financial cycle. According to a study ‘the revenue cycle management market is projected to reach US$ 216,990.6 million in …

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Measuring The Effectiveness Of Revenue Cycle Management In Healthcare

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Healthcare providers are more focused on improving the quality of care but at the same time, they remained concerned about reimbursements and collections. The lack of financial automation tools and the availability of limited resources bounds them to rely on conventional methods. Using the conventional approach to manage the revenue cycle, it is difficult to …

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