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From insurance notifications to prior authorizations: Streamlining processes to empower nurses and enhance patient care
During times of ongoing healthcare staffing shortages, today’s nurses face unprecedented pressure in the workplace. Although longer-term staffing projections look favorable, scarcity of nurses will likely continue in the short-term. Nationally, there is a projected shortage of 78,610 full-time equivalent (FTE) RNs in 2025 and a shortage of 63,720 FTE RNs in 2030. As healthcare organizations try to meet patients demands using existing resources, nursing burnout continues to increase. Unfortunately, the dangers of nurse burnout are dire: Lower healthcare quality and safety and lower patient satisfaction. This is the antithesis of what nurses want. They entered the nursing profession to take care of patients—not harm them.
Why financial sustainability starts with effective provider credentialing and enrollment (and how to achieve it)
While today’s healthcare organizations come in all shapes and sizes (e.g., critical access hospitals, rural hospitals, urban hospitals, physician practices, and more), there are at least two fundamental commonalities: Providers must meet specific qualifications and standards to treat patients, and providers must register with payers to receive reimbursement.
How to Find a Revenue Cycle Specialist
Managing the revenue cycle for a busy medical practice, clinic, or hospital is no easy task. It requires a skilled team to handle medical billing, process claims, and ensure payments are collected on time. For revenue cycle leaders, keeping a full team staffed can feel like a constant struggle. When team members leave or the workload increases, the first instinct might be to hire a new full-time specialist to join the team. While this seems like an obvious solution, it’s important to consider all the factors involved in this decision—and explore other options that might be more effective.
How To Streamline GLP-1 Prior Authorization and Increase Access to FDA-approved Drugs For Obesity
Prior authorizations create administrative burdens for hospitals nationwide, and new weight loss medications—known as GLP-1 receptor agonists—exacerbate existing revenue cycle management challenges. This is especially true in today’s rural healthcare facilities and critical access hospitals where profound healthcare staffing shortages persist.
5 Benefits of Working With an Onshore RCM Outsourcing Partner
As organizations continue to face unprecedented healthcare staffing shortages, leaders increasingly look to revenue cycle management outsourcing for relief. In fact, healthcare leaders say outsourcing is their top strategy to combat these challenges. Why outsource revenue cycle management? If you don’t have enough staff, you can’t submit accurate and timely claims, and as many chief financial officers say, ‘No money, no mission.’ Without cashflow, it becomes difficult to provide high-quality patient care. It’s a harsh reality, but it’s true.
Optimize Your Healthcare Revenue Cycle with Expert Hourly Medical Billers
The right team and resources on your revenue cycle management (RCM) team are crucial to financial success. But managing your billing processes efficiently can be a challenge, especially when your medical billing team faces unexpected staff shortages, peak workloads, or gaps in expertise. That’s where hourly medical billers come in – a cost-effective, flexible solution that keeps your operations running smoothly, without the burden of full-time hires.
The Crucial Role of Claim Denial Management in Optimizing Hospital Reimbursements
Revenue cycle management takes up a significant amount of time and resources in healthcare finance and one of the most challenging areas is claim denial management which directly impacts a hospital's ability to optimize reimbursements. Understanding key terms associated with denial management is not just beneficial; it's essential for enhancing financial health and operational efficiency.
The Role of Assessments in Optimizing the Revenue Cycle
Regular optimization of your revenue cycle is crucial for maintaining financial stability and driving growth. By assessing your revenue cycle processes and workflows, you can uncover performance issues and discover actionable solutions that enhance your bottom line. If you're concerned about your hospital's revenue cycle performance and suspect there are opportunities for improvement, a comprehensive assessment could be the key to unlocking hidden revenue potential.
Streamlining Hospital Revenue Cycle Staffing with Staff Augmentation
A significant percentage of hospital revenue cycle departments are grappling with medical billing staff vacancies. The hiring process to fill these positions can be lengthy and cumbersome, causing considerable strain on existing teams. Managers must juggle posting job openings, sifting through applications, evaluating candidates' skill sets, and conducting interviews—all while ensuring their departments continue to function effectively despite being short-handed.
Want to promote revenue integrity and stop the endless cycle of claim denials? Hire experienced medical billers.
It’s a mantra we’ve all heard before: You get what you pay for. The idea is that saving more on the front end sometimes ends up costing you in the long run. When it comes to revenue cycle management (RCM), this couldn’t be truer. While it may be tempting to hire less expensive novice medical billers, doing so may negatively affect your revenue integrity (i.e., your ability to get paid accurately and completely for the services you provide). When you hire a medical biller with less experience, you save money on their salary, but you may lose money on the back end through claim denials, underpayments, and write-offs.
Patient Check-In Changes Improve Hospital Revenue
Improving the front-end registration process in hospitals is essential for reducing insurance claim denials, which can significantly impact a hospital's revenue and operational efficiency. Here are some evidence-based strategies to optimize the front-end process and minimize claim denials.
Maximizing Revenue Recovery: A Guide to Improved Payer and Patient Cash Flow
Managing revenue recovery has become a crucial aspect for healthcare providers and institutions. The complexities of claims and the frequency of denials can significantly impact the financial health of medical practices and hospitals. However, with a strategic approach and deep expertise, it is possible to navigate these challenges and ensure that earned reimbursements are recovered efficiently.
Why a central billing office and other RCM best practices help rural hospitals achieve positive operating margins
Positive operating margins may be difficult for rural hospitals to achieve. However, leveraging a central billing office—or CBO—and other revenue cycle management (RCM) best practices can help these organizations thrive financially.
Outsourcing Revenue Cycle Management in Healthcare Can Pay Off
Healthcare organizations are increasingly turning to outsourcing their Revenue Cycle Management (RCM) to enhance financial performance and operational efficiency. This strategic shift not only aims to mitigate the rising costs associated with in-house medical billing teams but also to leverage the expertise, experience with EMRs and EHRs and efficiency improving technology provided by specialized vendors.
How to Retain Good Medical Billers and Other Workforce Members
Retaining skilled employees is crucial for any industry, but it holds particular importance in healthcare. It’s tough to find the right people for the right seat in your workforce. Once you have those employees you need to have a strategy for ensuring the investment you made hiring and training them continues to add for your organization.
How Patient Price Transparency Creates Hardships for Rural Hospitals (and what to do about it)
Price transparency regulations aimed to promote patient empowerment also create unintended negative consequences for today’s rural hospitals. Here’s how revenue cycle management teams can navigate requirements with greater ease.
What is Revenue Cycle Management?
In the complex ecosystem of healthcare, managing the flow of revenue is a critical task that ensures the sustainability of care providers and the institutions they work for. Revenue Cycle Management (RCM) is a term that might sound daunting at first, but it's essential for anyone involved in healthcare administration to understand its intricacies and impact.
The Challenges Hospitals Face with Revenue Cycle Management
In the complex world of healthcare, revenue cycle management (RCM) is a critical aspect of a hospital's financial health. RCM involves the management of administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. While it may not always be in the spotlight, RCM is an essential component for hospitals to ensure financial sustainability and provide high-quality patient care. In this blog post, we will explore the challenges hospitals face with revenue cycle management and highlight the importance of effective RCM practices.
Why Investing in Revenue Cycle Management Promotes Financial Sustainability for Critical Access Hospitals
“The current climate makes prioritization of an efficient revenue cycle department paramount,” says Jeneisa Sudbrink, CRCE, Chief Operations Officer at InlandRCM. “These and similar statistics serve as a wake-up call for today’s rural healthcare leaders who must think about ways to promote financial sustainability. That means looking specifically at the effectiveness of revenue cycle management [RCM] within the organization.”
How a Central Billing Office (CBO) Enhances Your Hospital's Revenue Cycle
A Central Billing Office (CBO) tackles many challenges in medical billing, significantly boosting your hospital's financial performance. By handling front-end edits and proactively managing denials, CBO experts ensure that claims are accurate, compliant, and promptly processed. This approach minimizes claim denials and delays in reimbursements, reducing financial strain on your hospital.