To wrap up the HealthStream Blog for the year, we did some research about our most popular blog posts. Of those published in 2018, these are the five most popular focused on the healthcare revenue cycle.
A strong trend in healthcare is for patients to assume a greater degree of financial responsibility for the cost of their care. This change has led many people to work to understand more “about the cost of care so they can shop around for services, plan for elective procedures, and budget appropriately.” To support the desire for greater transparency around healthcare costs, many healthcare organizations have begun “to rethink aspects of their revenue cycles, especially regarding pricing and cost estimation.” A recent HFMA Executive Roundtable sponsored by Change Healthcare, Healthcare Consumerism and Transparency in the Revenue Cycle, offers valuable insights about where healthcare is heading in this regard.
All staff with patient access responsibilities must perform effectively to ensure the success of the healthcare revenue cycle in its entirety. With the shift toward high-deductible health plans and the growth in newly insured individuals, Patient Access is faced with communicating and collecting increasingly larger amounts for which patients are financially responsible. In addition to patient communications, these employees must fully understand insurance plans, coordination of benefits, medical necessity and ABNS, and the importance of the demographic and insurance information they collect and record. This post collects HealthStream articles about the importance of training to healthcare revenue cycle management success.
In patient care, even when a problem is clear, the solution can often be difficult to pin down. The same is true of healthcare as an industry. Shortfalls in key staffing areas such as coding can create havoc on business operations and efficiency as fixes prove elusive. Like the ongoing nursing shortage, the coder problem looks different, not just between regions or states, but even down to communities. The availability of talent is a concern, as are training programs, salaries, and other elements that HR departments face all the time. And the solution? Like patients, it’ll be unique to every situation. This blog post excerpts an article, “Code Red: Medical Coding Staff Issues Can Create Reimbursement Bottlenecks and Other Problems.”
The average hospital loses $17.4 million annually in claim denials based on misidentification, according to the 2016 Ponemon Misidentification Report (Ponemon Institute). The study states, “On average, hospitals have 30% of all claims denied and an average of 35% of these denied claims are attributed to inaccurate patient identification or inaccurate/incomplete patient information.” Denials adversely affect both cash flow and AR days.
Like many other areas of healthcare, revenue cycle is not immune to challenges that can seriously affect the financial viability of an organization. However, solving big problems in healthcare is part of HealthStream’s DNA and a principle that we’ve enshrined in our corporate constitution. This post contains links to three webinar recordings focused on revenue cycle.
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