KPIs in RCM plays a pivotal role, as they help drive data-driven decision-making and creating business transformation projects. Whether you are running a physician practice or a hospital, adhering to the 6 KPIs listed below enables you to keep your revenue cycle in control. By Measuring and monitoring these KPIs, you will be able to extract the most out of your revenue cycle and find the much-needed cash to invest in technology and patient care.

Reducing reimbursement rates, increasing infrastructure costs, and shifts in payer mix create challenges for radiology practices. Download this guide on Radiology Best Practices to learn more.

RCM for Specialty healthcare can be daunting to most healthcare organizations, considering the frequent changes in regulations. In addition, it can be complex as it requires attention to financial & administrative challenges that usually have a hyperbolic effect on its financial stability. This article brings you a few revenue cycle management challenges in Specialty Healthcare and a few tools & strategies to overcome them.

Practitioners working on the healthcare revenue cycle need to be conscious of multiple state-specific rules and payer-specific nuances to be successful. AI can help simplify the complexities of today's revenue cycle. The usage of AI in RCM can be a gamechanger and help healthcare entities improve patient experience, improve collections, improve compliance, and reduce their RCM team members' workload. This article will help you understand the use cases for applying artificial intelligence in the revenue cycle.

A credential provider gets an increased number of patients through referrals from payers. Physicians/providers must credential themselves, i.e., enroll and attest with the payer's network and get authorized to provide services to patients who are members of the payer's plans. This article brings a few things that need to be checked off to ensure a hurdle-free credentialing process.

With COVID-19 vaccinations now being administered across the United States, we have compiled these medical coding guidelines to account for the treatment and vaccinations for the novel Coronavirus.

Ob/GYN billing & coding can be challenging to most billers & coders due to the global claims, widely varying coverage terms, and multiple tests performed at numerous facilities. Apart from this, many OB/GYN practitioners lack the billing support provided to large hospitals. Learn more about the challenges in Ob/Gyn coding and best practices followed by our coding experts.

Most Central Billing Offices (CBOs) and outsourced billing companies rely on dedicated accounts receivable calling to overcome their receivables' challenges. Running an AR calling team needs a solid understanding of the receivables patterns and diligent processes to follow-up and close underlying issues. In this article, we list some of the critical operational issues and solutions to overcome them.

As of January 1, 2021, there will be significant changes to the office and outpatient Evaluation and Management (E&M) services (CPT ® codes 99202-99215) for both new and established patients. Practices, physicians, and staff must be aware of the modifications to ensure a successful transition next year and avoid any reimbursement disruption. Their clinical documentation systems (EHR systems) need to be adjusted accordingly as per the 2021 E&M changes.

Global Medical Billing and Coding services teams hold the key to your financial success. As a medical billing services provider, you should let your clients know that you are utilizing global delivery. It is imperative that you bring up the capabilities of your offshore partner in such conversations.

Retaining Healthcare Provider customers is key to profitability for Medical Billing companies. Therefore, the role of exceptional service and achievement of revenue cycle KPIs is paramount

Three additional key performance indicators (KPIs) - patient slots occupied, point-of-service (POS) collections percentage, and days to claim submission from the date of service (DOS) are key to running a successful practice.

Improving the overall patient experience requires a comprehensive re-look at your clinical, administrative, and financial processes. From reducing time to care delivery to improving transparency around the costs of care, healthcare provides need to focus on improving quality, timeliness, and responsiveness.

Inefficient payment posting can be a cause of extended days in A/R – creating frustration for your clients. High labor costs with this department can cut into your profitability. Efficient Payment Posting can provide the right visibility into your revenue cycle performance.

With changes in technology, a successful medical biller needs to understand (and be proficient) in using technology, applying deductive and critical thinking skills, and be an excellent communicator. Ideally, one should look for strong analytical, communication, and inter-personal skills in a medical biller

Emergency departments are fast-paced environments where care is delivered quickly depending on the patient's condition's criticality. Further, ED does not deal with one specialty per se. ED provides Medical services across specialties. It also requires close coordination of services from when a patient enters an ambulance or an ED facility to discharge, working with multiple clinical practitioners. Learn more about ED coding best practices in this guide from Medical Billing Wholesalers..

Many Primary Care Physicians lose money because of lack of understanding of payer specific claims submission guidelines. Educating physicians on their documentation responsibilities is an iterative process, that requires an understanding of the reasons for claim denials, ability to nail-down the issues that are causing the denials, determining the corrective actions, and hosting timely sessions between the denials team and the physicians to discuss them.

Most revenue cycle systems have a wealth of unutilized functionality. Revenue cycle professionals need to evaluate workflow and reporting functionality on the revenue cycle system to not only ease their workload but also improve revenue cycle outcomes. Read more in this case study.

Internal medicine can be defined as the medical specialty dedicated to the diagnosis and medical treatment of adults. With so many new codes introduced and trickier coding, claim denials have increased for many internal medicine practices. Keep your coding team updated with the latest best practices in internal medicine coding with this guide from Medical Billing Wholesalers.

Physician credentialing is the process of obtaining, verifying, and assessing the qualifications of a medical practitioner to be able to provide medical services. Credentials are documented evidence of licensure, education, training, experience, or other qualifications of the medical practitioner. In this guide from Medical Billing Wholesalers, we bring you a few tips on successful provider credentialing.