Nearterm Blog
Posts by nearterm-admin
Current Issues in Healthcare Administration and Management
There are many healthcare management challenges in the U.S. today. Some of these problems have evolved slowly overtime as a result of growing, complex, and diverse healthcare offerings. Rising costs in almost every area have been impacting hospitals and other healthcare providers as well as patient willingness to seek care. Regulatory changes have also introduced…
Read More
“I promoted the best AR Specialist in our organization to a management position – oops!”
Here is a story from one of our clients that you may find interesting; Things were in good shape in our revenue cycle management process. Metrics and the Dashboard indicated that we were current in billing, follow-up, and cash application. Denials were under control. Days were low. Patient complaints were handled promptly. You get the…
Read MoreSILENT IMPRESSIONS
Every encounter we have with another person or a business results in an impression. An encounter may be conversation, email, voicemail, text, social media, appearance, hygiene and others. Some of the impressions we form based on these encounters are stronger than others and because people are all different, reactions vary. Some impressions are indelible and…
Read More
Improving Denial Management in Healthcare & Medical Billing
When insurers deny medical claims, it takes a bite out of your revenue every year. Nationwide, this annual loss amounts to $262 billion, according to Modern Healthcare. As a matter of fact, insurers deny an average of 9 percent of claims overall, which means that your staff is engaged in a continual process of managing and appealing…
Read MoreRevenue Integrity & Capture – Who’s Herding the Cats?
Cross functional processes can be difficult to manage in hospitals. One reason pertinent to Revenue Integrity is that typically, the organization structure is a series of vertical disciplines with differently defined focus (HIM, PFS, PATIENT ACCESS, ANCILLARY DEPARTMENTS, MD’s, et.al.). This structure can be and is very effective in many hospitals. However, revenue integrity management…
Read MoreRevenue Cycle Processing Backlogs Are Not “NORMAL”. It’s time to raise the bar – eliminate BACKLOG TOLERANCE!
I talk every week with Revenue Cycle Leaders from all types of hospitals around the country. When I ask how things are going, there are many common responses that reflect current concerns and challenges they are facing. These include conversion issues, staffing constraints, volume fluctuation, talent acquisition/retention, cooperation among stakeholders, change in payor practices and…
Read More
Hospitals Staffing Levels Improve With RCM Solutions
There’s no doubt that healthcare workers are the backbone of the health service, so it makes sense for a healthcare provider to manage their staffing levels in a strategic manner. Healthcare revenue cycle management consulting services (RCM) help hospitals to meet staffing needs while saving money. This cost-effective approach is gaining momentum as healthcare providers strive…
Read More
Should Hospitals Leverage Outsourced Coding or Keep It Internal?
Hospitals have adapted many different coding models. Most are designed around contributing factors that differ from one facility to the next. However, there are three models that arguably prevail. The following is a summary of each; MODEL I-INTERNAL All coding functions are managed and performed by internal staff/employees. The function is generally housed at the…
Read More
Hospital Classification: A New Normal For Financial, IT and RCM Professionals
Hospitals have been and still are classified in various ways, depending on the purpose of the hospital classification and how it is to be used. Examples include ownership, bed capacity, service capacity, specialty, teaching, acute care, critical access, location, research and there are many others. A “new normal” classification methodology has emerged and it is…
Read MoreRevenue Cycle Management In 1951: It Used to be a Lot Easier…Or Was It?
The above image is an actual hospital bill and accompanying explanation of charges used in 1951. Just think of the things that we didn’t have to manage back then. A short list might include coding, claim edits, massive denials, contract payment compliance, Medicare/Medicaid (both started in 1965), managed care contracts, HIPPA regulations, “patient-friendly” billing initiatives,…
Read More