The Best Way To Maximize Your EMR

A doctor filling out a patient medical record.

Providers today are better informed and are prepared to take on more challenges due to the information and flexibility that EMRs provide, yet this technological tool is not without its downfalls. EMRs are notoriously hard to navigate, especially when performing manual reviews. Being a strong source of information is detrimental when people have to manually […]

Improving Hospital Denials by Department

Doctors wheeling a patient in a bed down a hallway at a hospital.

A hospital’s denial issues vary based on the organization, and because of this, sometimes pinpointing potential denials can be difficult. Moving from a management to a prevention model is a slow process, and issues can potentially arise if denials by department are overlooked. However, the point of denial prevention is to move towards a denial-free […]

3 Things to Look for in a Revenue Integrity Partner

3 Things to Look for Revenue Integrity Partner FI

A revenue integrity partner is necessary for building a broader understanding of organizational claims processes and improvement opportunities. A strategic partner can help decrease time to revenue and reduce administrative costs. Finding and onboarding a partner for your revenue integrity program involve both time and resources, making it important to find the right fit from […]

The Importance of Client Success in Your Revenue Integrity Partner

Revenue Integrity Partner Client Success

Hospitals and health systems seek partnerships that provide solutions to improve revenue integrity, and a partner that fosters client success is essential and allows you to manage your revenue cycle more effectively, creating a decreased time-to-money ratio. A sense of urgency, root cause analysis, subject matter expert, open and consistent communication, and frequent reporting are […]

The Importance of Technology Solutions From Your Revenue Integrity Partner

Revenue Integrity Partner Technology

One of the most important elements in a revenue integrity partnership is technology. When considering engaging a revenue integrity partner or optimizing your current strategy, a commitment to technology will be an asset to the revenue integrity management teams.  Healthcare has changed dramatically, even in the last decade, with greater access to technology. Technology enables […]

The Importance of Clinical Expertise in A Revenue Integrity Partner

Revenue Integrity Partner Clinical Expertise FI

When considering engaging a revenue integrity partner, it’s essential to focus on three main components: clinical expertise, the right technology, and proven client success, but for this article, we will focus on clinical expertise. Clinical expertise is critical in solving clinical and coding review challenges. Some important qualifications include:  Having a team of industry veteran […]

Six Common Root Causes of Hospital Claim Denials and Solutions that Increase Your Revenue

Hospital Claim Denails and Solutions

Since 2008, the American Medical Association (AMA) has taken the lead to bring reform to the medical billing and payment system. Even amidst the COVID-19 pandemic, the AMA played a crucial role in shaping the federal response to the omnibus legislative package in December 2020.  While healthcare organizations may still end up with a denial rate of […]

Key Considerations for Outsourcing Your Revenue Cycle

Outsourcing Revenue Cycle Management Considerations

Hospital systems could be in danger of losing $122 billion in revenue by the end of 2021. The American Hospital Association commissioned a study to examine the effects of the COVID-19 pandemic on hospital revenue. They found that hospital revenue will likely continue declining throughout 2021 to make up for the increase in drug, labor, […]

Revenue Integrity: Analyzing and Reporting

Revenue Integrity Analyzing and Reporting

In the healthcare industry, as with an industry involving business units, it’s common to see gaps form between clinical operations, coding teams, and patient accounting. This is a universal issue and not necessarily the fault of any one system. As a best practice, revenue integrity can be used to bridge some of these naturally occurring […]

3 Reports You Should Be Receiving from Your Denial Management Data

3 Denial Management Reports FI

Imagine a scenario where $150,000 in claims were denied in the first quarter of the year. However, through a thorough examination of the data in just three denial management data reports, your team is able to implement additional training for your team, review and adjust documentation for certain payers, and adjust the coding on specific […]