Tag Archives: Optum360

Roadmap to partnership: Keys to identifying the best revenue cycle partner for you

After careful scrutiny of productivity, processes and technology costs, many CFOs see the value in partnering with an external company that can take over day-to-day revenue cycle operations. Such a partner is built for revenue cycle management (RCM) and can likely do it better than most hospitals or health systems. For CFOs, it may make […]
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Roadmap to partnership: Assessing your current revenue cycle operations

Fee-for-service reimbursement is pretty cut-and-dried for revenue cycle managers. Profits revolve around billing, collecting from insurers and resolving patient claims on an individual basis. That’s not the case under fee-for-value models, where insurers capitate reimbursement for certain populations — a scenario that has revenue cycle management (RCM) leaders scrambling for ways to handle changes in […]
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Value-based reimbursement leads providers to externalize revenue cycle management

As value-based reimbursement becomes the norm, consumers demand better-quality care, and federal agencies put new regulations in place, provider executives are feeling the impact. And perhaps no leader feels the effects of these changes more so than the chief financial officer. Significant pressure is on CFOs to find new ways to manage their organizations’ revenue […]
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Build an ICD-10 rapid response team for revenue emergencies

Now that ICD-10 is a reality in the U.S. health care environment, providers are finding that October 1, 2015, didn’t bring with it the D-Day scenario they thought it might. But they also know ICD-10-related challenges that aren’t apparent now might manifest themselves in the coming months. Providers were certainly ready to submit claims come […]
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Positive signs in early results — reasons for optimism regarding ICD-10 productivity

One of the biggest unknowns of the ICD-10 implementation is the effect on coding productivity. Experts have estimated the expected loss in productivity post-ICD-10 as HIM professionals climb the learning curve, and studies of other countries’ post-ICD-10 loss unveil valuable insights. One of the best studies on time loss published in 2014 revealed that participants […]
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A saving grace? What the new grace period does and does not mean for ICD-10 unspecified coding

With the recent Centers for Medicare and Medicaid Services (CMS) announcement of a ‘grace period’ related to ICD-10 coding specificity for Part B physician claims, there is a spotlight on unspecified ICD-10 codes. But how much will HIM leaders need to worry about unspecified codes? According to a recent review of more than 30,000 dual-coded […]
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Ten principles to help you engage providers around ICD-10

With less than three months until the ICD-10 go-live date, you may still be having trouble engaging providers around the new code set. If so, that’s not surprising. While we know that patient care will ultimately benefit from ICD-10’s increased specificity and data detail, doctors are focused on the here and now. And frankly, they […]
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Pressure to perform: What health care finance leaders are thinking

Today, hospitals are reeling from financial and compliance pressures due to a combination of bad debt, newly covered patients, changing reimbursement models, and the risk of denials in the face of the migration to ICD-10. Health care organizations are looking for more effective and new approaches to optimizing revenue cycle management performance across the enterprise. […]
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