Tag Archives: medical necessity

A critical link between patient engagement and payment resolution

With patient satisfaction scores playing a bigger role in health care providers’ financial bottom lines, hospitals and health systems must pay attention to all interactions with patients, including the billing process. This may require reviewing and updating your revenue cycle. Recently, Becker’s Hospital Review recapped insights from revenue cycle management (RCM) leaders shared over the […]
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Medical necessity is a must for any value-based organization

In our previous post, we outlined how optimizing the technologies and processes behind clinical care is critical to optimizing performance in a value-based environment. The next step on the journey “Beyond the Curve of Health Care” involves medical necessity. Medical necessity can be burdensome, but its various rules must be followed to avoid significant penalties […]
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Optimize performance to accelerate your value-based journey

It’s no secret that health care providers have abundant opportunities to save. Some estimates put the dollar figure in the hundreds of billions in revenue that is lost due to unnecessary expenses, missed income and inefficiencies each year. Executives can play a vital role here in reclaiming these lost resources. You can analyze and pinpoint […]
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The journey to value: From finances to patient access, get your house in order for fee-for-value

Health care is driven by the wants and needs of the market. Consumers want better transparency and value at the same time governments, payers and employers are trying to keep costs down and stimulate quality improvement. This means more pressure on providers to deliver efficient care while not passing on costs to patients. But, making […]
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The journey to value: Navigating the journey from providing care to managing health

There’s little doubt that health care is transitioning from fee-for-service to fee-for-value. Everyone seems to be getting on board: commercial payers are spending billions on risk-based contracts while the Centers for Medicare and Medicaid Services (CMS) is putting its clout behind its accountable care organization (ACO) and other value-based purchasing initiatives. What’s not clear is […]
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