As hospitals deliberate ways to take in the looming Medicaid changes introduced by the One Big Beautiful Bill Act (OBBBA), one thing is crystal clear: RCM readiness is more critical than ever to offset the financial impact this policy could bring.
Accounts Receivable (AR), AR Days, AR management, Denial Management, Revenue Cycle Management
The Art of Appeal: Maximizing Revenue with Appeals-First RCM
An appeals-first mindset—rather than defaulting to write-offs—can be your best weapon in healthcare RCM to reclaim revenue that rightfully belongs to you, while wielding your denial management skills with learnings from each case.
Accounts Receivable (AR), AR Days, AR management, Denial Management, Revenue Cycle Management
Why Low AR Days Don’t Always Mean Good Things for Your RCM
Low accounts receivable (AR) days may feel like a coveted trophy—a sign your team is crushing it with lightning-fast collections—but the metric can be pretty misleading in healthcare revenue cycle management (RCM).
Here’s the kicker. Without the right context, low AR days may not always mean real revenue cycle success. In fact, the metric can mask issues that could be silently impacting your bottom line.
Denial Management, Prior Authorization, Revenue Cycle Management
Fixing Healthcare’s Achilles’ Heel—Prior Authorization Â
Prior authorization pain is felt most acutely by patients and providers, who bear the brunt of hidden costs and care delays. By insisting on clear denial explanations, pushing for regulated response timelines, and modernizing front-end processes, providers can move away from bureaucratic inefficiencies toward better outcomes.
Accounts Receivable (AR), Denial Management, Prior Authorization, Revenue Cycle Management
Unlocking RCM Wins: Turning Setbacks into Success Â
Stuck in this everyday grind amid challenges like shifting payer behavior, changing regulations, and growing staffing shortages, providers are now making a conscious effort to re-innovate their RCM strategy to keep the ball rolling
Denial Management, Revenue Cycle Management
Claim Denials: Have You Addressed This Elephant in Your Revenue Cycle Yet?Â
Over the last five years, unresolved claim denials have increased at an alarming rate of 20%, with health systems losing at least $500,000 annually to denials, driven by factors such as coding errors, incomplete documentation, and lack of compliance.
Denial Management, Revenue Cycle Management
RCM Simplified: 5 Ways to Achieve Faster Medical Claim Settlements
Medical claim settlement is one of the top challenges faced by healthcare organizations and insurance companies alike. The major cause of this challenge is the
Denial Management
Denial Management Workflows: A Step-by-Step Approach to Boost Revenue
The “National Hospital Flash Report: April 2023” indicates that US healthcare providers are struggling with more denials of claims. This problem influences patient treatment and
Denial Management
Revenue Cycle 101: Understanding Denial Management in HealthcareÂ
In the ever-evolving healthcare landscape, claim denials often become a thorn in the side of providers and physician practices, costing them financially and draining them
Denial Management
How Providers Can Leverage AI in Denial Management for Effective RCM
Claim denials continue to be one of the most dreaded setbacks for healthcare providers, tormenting their revenue cycle and costing them a staggering $20 billion
