Topic: Denial Management

Top 10 Claim Adjustment Reason Codes (And Strategies to Avoid Them)

Top 10 Claim Adjustment Reason Codes (And Strategies to Avoid Them)

According to the American Hospital Association (AHA), 78% of healthcare organizations report worsening experiences with commercial payers. Additionally, 84% noted rising costs of complying with insurer policies, and 95% said staff were spending more time on prior authorization processes. That’s why it is important to understand the root cause of these denials to not only quickly resolve them, but also avoid them altogether.

Physician Billing Services Guide: From Denials to Revenue Recovery

Physician Billing Services Guide: From Denials to Revenue Recovery

Billing is the lifeline of physician practices, and every dollar lost to inefficiency or error is a dollar that could support patient care. Gaps in billing processes, frequent denials, and staff shortages can derail financial stability, making it harder to keep operations running smoothly.

What is Revenue Cycle Management?

What is Revenue Cycle Management?

For hospitals, health systems and physician practices, delivering excellence in care and providing the best outcomes for patients drive what you do. However, there is a financial side to healthcare, and it’s highly complex.

KPIs: Where to Focus Time and Effort

KPIs: Where to Focus Time and Effort

Health systems and provider organizations are facing enormous challenges. In a recent poll, providers ranked five of their most pressing issues, which were staffing (58%), expenses (20%), revenue (17%), technology (2%), and other (2%).

4 Tips for Simplifying Prior Authorizations

4 Tips for Simplifying Prior Authorizations

Until new legislation becomes law, providers need to do all they can to automate prior authorizations, standardize processes, maintain highly qualified staff and improve patient communications.

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