Revenue cycle faces unprecedented challenges, but old truths point the way to new solutions

Jesse FordCOVID-19, Revenue Management

We’ve done it before. While we cope with financial and mental stress in an uncertain environment, revenue cycle leaders can draw upon the well of experience they have in adjusting to previous change in our dynamic healthcare industry. We’ve withstood several downturns in the economy. We’ve overcome vast changes in the payer market, reimbursement systems, coding systems and new technology. … Read More

Want some good news? Start with recovered cash today, and much more to come through automated processes and understanding of payer behavior

Frank MassiRevenue Management, Zero balance

Despite the return of elective procedures at most hospitals and outpatient centers, not nearly enough patients have been showing up, perhaps fearful of what they perceive as high-risk environments. As a result, healthcare’s COVID-19-fed economic downturn has reached epidemic proportions, leaving organizations of all types and sizes scrambling to identify any new or accelerated sources of revenue. Instead of mass … Read More

While AI in healthcare matures, finding the right data is a starting point

Jesse FordRevenue Management

In our fall newsletter, I asked, “Has AI really arrived in healthcare revenue cycle?” I shared that as a company born in a digital age, Salud recognizes the need to collect, store, and analyze clinical and financial data that can help predict outcomes and improve processes that affect cash. However, I questioned then and continue to question whether the industry … Read More

Salud connects the dots to help providers use the rev cycle to connect with patients as consumers across the enterprise

Frank MassiRevenue Management

In our fall newsletter we talked about how self-pay can be turned in to a provider advantage through “consumerization.” We also discussed how Salud organizes around the patient-as-consumer via an organization-wide commitment to provide revenue cycle managed services that are “connective, predictive and prescriptive.” This consumerist outlook was bolstered by the work of two major organizations, the Healthcare Financial Management … Read More

Has AI really arrived in healthcare revenue cycle?

Jesse FordRevenue Management

It’s safe to say that healthcare has come a long way from its low-tech past. Until just a few years ago, paper was still the foundation for most healthcare processes. We spent tens of billions of dollars, much of it government money, to adopt electronic medical records, for better or, in all too many cases, for worse. Interpersonal communications went … Read More

How self-pay can be turned into a provider advantage

Frank MassiRevenue Management

Consumer? Consumerism? Consumerization? In the context of healthcare, all three evoke different perspectives (and emotions) regarding the healthcare continuum and the end-to-end patient experience. From a revenue cycle perspective, for what is known as the “patient financial experience,” the word we use is consumerization. This implies action, and lots of it; an ongoing effort universally acknowledged and urgently needed to … Read More

Payer Collaboration Leaders Could Ease Payer, Provider Tensions

Jesse FordRevenue Management

Though considerable tensions remain over narrow (and narrowing) provider networks and coverage and claims disputes, I see a continuingshift toward greater cooperation. With all of the financial pressures on both sides of the chasm, building bridges seems more fruitful than lobbing mortar shells. Read the article.

There’s Gold in the Zero Balance Review

Jesse FordRevenue Management

After claims are closed, most hospitals and health systems, many with six figures’ worth of claims annually, will not review accounts that have been paid or adjusted off. Certainly, they will look at outright denials, especially if there is a pattern. But closed claims mostly have been the Dead Letter Offices of the healthcare system. And yet, there may be gold … Read More