Revenue Cycle Management

This section includes coverage on the many facets of the revenue cycle food chain for hospitals and physician group practices. Topics span insurance eligibility, charge capture, claims coding, claims submissions, claims clearinghouses, and back-end follow-up with insurance companies to rectify claims denials and resubmission requests.

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AMA Board to Members: Skipping ICD-10 for ICD-11 Not Recommended

Joseph Goedert | May 16

A new report from the American Medical Association Board of Trustees concludes that the advantages of skipping implementation of the ICD-10 code sets and waiting until ICD-11 are outweighed by the disadvantages.

Coding

Electronic Data Interchange

Group Practices

Hospitals

Payers

Policy & Regulation

Revenue Cycle & Payments

200 Million Rows of Data and Counting

Gary Baldwin | May 13

At the University of Utah Hospitals and Clinics, the former cost-modeling effort was a bit of a crapshoot when it came to accuracy.

Consumer Health

Decision Support

Revenue Cycle & Payments

Allscripts Stock Dips on Poor First Quarter

Joseph Goedert | May 10

The stock price of Allscripts Healthcare Solutions fell 5.6 percent at the open of trading on May 10 as the software vendor announced first quarter 2013 results that significantly missed investment analyst expectations.

Hospitals

Group Practices

EHR

Electronic Data Interchange

Practice Management

Revenue Cycle & Payments

Vendor News

Revenue Cycle Management

May 09

Mounting pressures prompt providers to zero in on revenue cycle management. Health care organizations and medical practices are struggling with less than ideal financial conditions as well as the imminent shift from ICD-9 to ICD-10 coding. These struggles along with the move toward new payment models present significant challenges for health care organizations. Hospitals are expected to focus keenly on RCM to prepare for the changes that lie ahead. Find out what how RCM is helping solve the problem.

The Fight to Better Manage Revenues

Gary Baldwin | May 07

When it comes to managing the revenue cycle, David Kanzler takes a pragmatic approach-he outsources a good chunk of it.

Revenue Cycle & Payments

Group Practices

Hospitals

Electronic Data Interchange

Policy & Regulation

Payers

Let Them Eat Cake — Study Frosts Argument For Tort Reform

Greg Goth | May 07

In the almost two decades I've been a health and tech policy wonk, I've heard exactly two utterances that could and should be etched in medical economics stone:

Policy & Regulation

Revenue Cycle & Payments

AMA Defends Cloning EHR Data, Calls for Reconsidering Stage 2 Criteria

Joseph Goedert | May 06

Disputing that physicians are purposely using electronic health records to generate higher Medicare billings and “gaming the system,” the American Medical Association says federal policies themselves put providers in a Catch-22 situation. One fix, according to the AMA, is to reconsider Stage 2 meaningful use requirements.

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EHR

Group Practices

Payers

Policy & Regulation

Hospitals

Revenue Cycle & Payments

Coding

Stimulus

60 Seconds Smarter: ICD-10

May 06

The tenth edition of the International Classification of Diseases is set to be rolled out in the United States, and getting smarter about ICD-10 is critical for all industry stakeholders.

Coding

Disease Management

EHR

Hospitals

Payers

Policy & Regulation

Revenue Cycle & Payments

Vendor News

New Leaders at Software Vendor TriZetto

Joseph Goedert | May 06

The board of directors at payer/provider software vendor TriZetto Corp. announced on May 3 that Chair and CEO Trace Devanny was leaving immediately to pursue other options.

Payers

Group Practices

Hospitals

Electronic Data Interchange

Revenue Cycle & Payments

Vendor News

Free Software to Aid Analysis of Medicare Claims Data

Joseph Goedert | May 03

Archimedes Inc. is offering free data analytics software to analyze Medicare claims data from 2008 through 2010 under a collaboration with the Centers for Medicare and Medicaid Services.

Coding

Electronic Data Interchange

EHR

Group Practices

Hospitals

Payers

Revenue Cycle & Payments

Policy & Regulation

Editor's Note: Analyzing the Real World

Greg Gillespie | May 01

A recent report by research firm IDC Health Insights tagged analytics as the No. 1 technology priority for organizations engaging in accountable care.

Data Repositories

Decision Support

EHR

Group Practices

Hospitals

Payers

Revenue Cycle & Payments

Consumer Health

Chronic Care

Squeezing out the Revenue

Gary Baldwin | May 01

Providers look to untangle the often convoluted financial food chain.

Hospitals

Group Practices

Practice Management

Revenue Cycle & Payments

Greenway Stock Tanks as Revenue Model Changes

Joseph Goedert | Apr 29

The stock price of ambulatory software vendor Greenway Medical Technologies fell almost 23 percent on April 29 then immediately gained 4 percent in after-hours trading after the company significantly downgraded its financial performance for the rest of fiscal 2013, which ends on June 30.

Vendor News

Group Practices

EHR

Practice Management

Revenue Cycle & Payments

CMS to Vastly Increase Rewards for Fraud, Abuse Whistleblowers

Joseph Goedert | Apr 24

A new proposed rule from the Centers for Medicare and Medicaid Services would put a lot more money behind rewards for information on individuals or entities engaging in Medicare fraud and abuse.

Payers

Group Practices

Hospitals

Electronic Data Interchange

Practice Management

Revenue Cycle & Payments

Policy & Regulation

AAFP: Primary Care Docs Do More, Should be Paid More

Joseph Goedert | Apr 16

The American Academy of Family Physicians is calling on the Centers for Medicare and Medicaid Services to develop a new set of evaluation and management codes specifically for primary care physicians.

Coding

Group Practices

Payers

Revenue Cycle & Payments

Policy & Regulation