Revenue Cycle Management
Healthcare providers rely on revenue cycle management (RCM) systems and processes to handle crucial financial functions, including invoice processing, claims management, reimbursement, accounting, payroll, insurance, compliance, and taxes. By helping patients navigate their payment obligations, RCM systems not only ease the administrative burden on providers but also improve the overall financial health of the organization. To know more, read our Revenue Cycle Management special issue.
Reimagining Revenue Cycle Operations in a Changing Healthcare Environment
By Jennifer Dzendzel, Director, Revenue Cycle, Patient Access, Financial Counseling & Estimates, and Bret Stearns, Director, Revenue Cycle, Enterprise Facility Billing, University of Virginia Health System At UVA Health, we take pride in our integrated revenue cycle, anchored by a ...
Making Revenue Cycle Work Smarter
By Amy Simpson, Revenue Cycle/Pre-Service Operations Director, Wellstar Health System Automation has transitioned from a future consideration to an essential component across all facets of the revenue cycle. The integration of automation platforms is critical for scalable healthcare organizations, necessitating ...
Healthcare’s Next AI Problem Isn’t Innovation. It’s Execution.
By Abishek Bhat, VP Business Development, Trigent Software If you talk to healthcare IT leaders today, the conversation around AI feels noticeably different from even a year ago. Not long ago, most discussions were centered on experimentation, piloting documentation tools, ...
The Role of Revenue Integrity in the Clinically Driven Revenue Cycle
By Ashley Yeo, System Director, Revenue Integrity, Northern Arizona Healthcare The evolution of electronic health records (EHRs) has fundamentally transformed health care operations, leaving revenue cycle processes permanently changed. The industry has shifted from traditional models where revenue cycle functions ...
Driving Revenue Cycle Transformation Through Analytics, Automation, and AI
By Michael Laukaitis, Director of Revenue Cycle Analytics, Accounting and Quality Assurance, UT Southwestern Medical Center The revenue cycle has never been a static function; however, in recent years, it has evolved faster than ever. At our organization, the revenue ...
Leveraging AI, Automation, and Data Analytics in a Hospice Setting
By Lindsay Myers, VP of Revenue Cycle & HIM, Chapters Health System In the hospice setting, the revenue cycle is not only complex but also uniquely fragile, as billing cannot proceed without complete documentation. The sequential nature of hospice billing, ...
Strategic Evolution of RCM: Leveraging AI and Automation for Operational Excellence
By Evan Martin, VP of Revenue Cycle, ZoomCare As VP of revenue cycle at ZoomCare and host of the Wilshire IT RevCast RCM & IT podcast, I spent four years exploring automation's transformative role in healthcare. Conversations with industry experts, ...
Ask Ascension! How the implementation of innovative chatbot features is helping streamline workflows
By Patricia Consolver, VP of Revenue Cycle Front End, Ascension In healthcare, where precision and effectiveness are essential, the revenue cycle is a crucial component. Ascension, one of the nation’s leading non-profit Catholic health systems, views optimizing the patient experience ...
Smarter Revenue Integrity with Artificial Intelligence
By Dr. Angela Comfort, AVP of Revenue Integrity, Montefiore Einstein Medical Center Artificial intelligence (AI) has moved beyond being a futuristic concept in healthcare. It is actively reshaping how hospitals, physician practices, and health systems manage their revenue cycle. Among ...
The Future of Revenue Cycle Management (RCM): AI and Data Analytics
By Candice Hoshi, VP of Revenue Cycle, UCHealth In today’s rapidly evolving health care landscape, sustainability depends on quickly addressing key areas within revenue cycle management. The pressure to deliver value and reduce costs is constant. At UCHealth, we’re leaning ...
AI and Automation: The Next Frontier in Revenue Cycle
By Keisha Downes, VP of Middle Revenue Cycle, Beth Israel Lahey Health Ten. That was the number of clicks it took me, using an encoder, to manually code a simple tension headache- G44.209. While clicks may seem like part of ...
Overcoming the Stalemate: Making Your Next Move on Revenue Cycle Technology
By Beth Carlson, CRCO, WVU Medicine As healthcare organizations navigate the complex landscape of digital transformation, revenue cycle technology has emerged as a critical component for driving operational efficiency and financial sustainability. Yet today, every department seems to be in ...
Power of Partnerships: How Macedon Technologies Accelerated Healthcare Automation for Neuromonitoring Associates
As the healthcare industry continues to evolve with regulatory pressure and economic strain, healthcare providers are increasingly caught between digital modernization and the operational inertia of legacy systems. Repetitive and manually driven workflows, as well as industry-wide trends like mounting ...
Leveraging AI in Revenue Cycle Management for Healthcare
By Jennifer Wheeler, VP of Revenue Cycle, Stone Diagnostics The integration of Artificial Intelligence (AI), automation, and data analytics into the revenue cycle management (RCM) of healthcare facilities marks a transformative leap toward operational excellence. In an era where financial ...
The Power of Numbers and Dashboards: A Data-Driven Strategy for Optimizing Revenue Cycle Management
By Ahmad Kilani, Medical Director and Nicholas Libertin III, Enterprise Physician Advisor, Cleveland Clinic The rise of physician advisors has been a transformative development in 21st century healthcare. Many healthcare systems have adopted an enterprise physician advisor model to streamline ...
Clinicians and Revenue Cycle: Why the separation?
By William Gress, RN, MHA, BSN, CHFP, CRCR, Director, Revenue Cycle Operations, Cottage Health Healthcare is a business unlike any other. Many economists describe healthcare as an imperfect market, where the consumer is not the one paying for the goods ...
Navigating the Complexities of Denials and Appeals in Healthcare Revenue Cycle Management (RCM)
By Dr. Angela Comfort, MBA, RHIA, CDIP, CCS, CCS-P, AVP Revenue Integrity, Montefiore Medical Center The healthcare industry faces continuous challenges in maintaining efficient RCM, which is essential for the sustainability and operational success of healthcare providers. A particularly challenging ...
The Value of an Audit
By Kelly Lanning, Director of Revenue Analysis, Detroit Medical Center Healthcare relies on audits to ensure they remain compliant and assist with identifying potential risks. Is your organization prepared? Audits occur on many different levels and have different areas of focus ...
Navigating Revenue Cycle Challenges: Strategies and Solutions Implemented by Our Organization
By Mea Ford, System VP of Revenue Cycle, Renown Health Navigating revenue cycle challenges, from billing errors to insurance denials and patient collections, requires diligent effort and strategic approaches. Automation has proven invaluable in streamlining processes and reducing errors, supported ...
Too Many Walls and Not Enough Bridges: Bringing Together the Great Minds of Revenue Cycle and IT
By Beth Carlson, VP of Revenue Cycle, WVU Medicine One of the simple truths is that “none of us is as smart as all of us.” This rings especially true as IT and revenue cycle teams seek to establish a ...
A People-First Approach: Optimizing Reimbursement through Engaged Teams
By Lynn Ansley, VP RCM, Moffitt Cancer Center Aligning professional development and succession planning within revenue cycle management (RCM) begins with getting the right people on “the Bus.” This enhances operational efficiency and accuracy, increases team member engagement, and optimizes ...
Revenue Cycle: The Healthcare Delivery Experience Bookends
By Willie Brown, VP of Revenue Cycle, Sentara Healthcare During a recent leadership meeting with our CFO, we were reminded that as quiet as it is kept, an organization’s revenue cycle acts as bookends for the healthcare delivery experience. In ...
Transforming Revenue Cycle Efficiency Through Integrated Leadership
By Katy Ryan Michaud, VP of Revenue Cycle, Franciscan Missionaries of Our Lady Health System In the post-covid world, revenue cycle teams face unprecedented challenges and opportunities. The industry is evolving rapidly, requiring teams to adapt to changing regulations, technologies, ...
North American Partners in Anesthesia (NAPA): New value-driven MSO/RCM services offer hospitals innovative solutions
Health system economics are increasingly under pressure. Challenged by nationwide clinical staffing shortages, decreasing reimbursements from government and private payors, and the increased administrative burdens associated with a value-based care environment, hospitals are seeking new strategies and solutions to ensure ...
Revenue Boosting Strategies to Implement this New Year, 2024
By Anneleah Williams-Bridges MS, RHIA, CCS, CCS-P, CCDS, RH-CBS, ACDIS Leadership Council, AHIMA Approved ICD-10 Trainer Hospital executives and leadership are actively seeking ways to increase revenue flow and optimize their organization's bottom line. We will explore five essential revenue-boosting ...
The evolving role of automation in the transformation of healthcare revenue cycle
By Sheldon A Pink, President & CEO, Krystal Rock Innovation Group Automation is taking the healthcare industry by storm. Every organization is exploring opportunities to invest in Robotic Process Automation (RPA), Machine Learning (ML), or Artificial Intelligence (AI). Even though ...
Strategic Approach to Revenue Cycle Management (RCM)
By Karina Checo, Director of Revenue Cycle, Bergen New Bridge Medical Center The revenue cycle sector of healthcare has seen a dramatic evolution in roles over the last decade. Daily tasks have changed to accommodate regulatory, technological, and payer behavior ...
Navigating the Automation Maze: Revolutionizing Revenue Cycle Management (RCM)
By Kris Seymour, Director, Revenue Cycle Transformation and PMO, WellStar Health System In the ever-evolving healthcare landscape, RCM stands as a critical aspect that ensures financial stability for healthcare providers. However, the journey of optimizing revenue cycles is fraught with ...
Navigating the Medicaid Redetermination Maze
By Seth Jeremy Katz, VP of HIM and Revenue Cycle, Finance, University Health of Kansas City Medicaid serves as a vital lifeline for millions of Americans, offering essential support during health-related challenges. Despite its indispensable role, the program has often ...
Marshfield Clinic Health System’s Technology-Driven Revenue Cycle Optimization
By Surya Ravulaparthy, VP of Revenue Cycle, Marshfield Clinic Health System Health care providers continue to experience financial pressures due to various internal and external factors, like declining reimbursement rates, rising inflation, declining workforce availability and complex regulatory requirements. Marshfield ...