Hayes' Healthcare Blog

Revenue Cycle Transformation Team

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Developing the ROI for Your Business Office Consolidation: 5 Key Questions

Posted by Revenue Cycle Transformation Team on September 13, 2017 at 9:00 AM

Merger and acquisition activity, the demand for cost reduction, and the need for better efficiencies have forced many healthcare organizations to implement a business office consolidation. While this may appear to be a logical step to meet the budgetary challenges facing hospitals and physician practices, you will still likely need to justify the disruption and expense of implementing the project. Before taking the plunge, you will need to calculate the ROI for the move.

Here are five questions to ask to help you develop the ROI for your business office consolidation project.

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Topics: revenue cycle management, revenue integrity

Managing Denials in a Valued-Based Reimbursement World

Posted by Revenue Cycle Transformation Team on March 8, 2017 at 9:00 AM

Claims denials continue to be a thorn in the side of most healthcare organizations. The transition from manual to electronic documentation and billing has helped but denial rates still consume an average of nearly three percent of an organization’s net revenue annually. In recent years, denials have grown to encompass 15-20 percent of the billing value of total claims. That can mean a $6 million hit for a 200-bed hospital to over $260 million for an 1100 bed facility.[1]

And things don’t figure to get any easier. The switch from fee-for-service to value-based care will complicate billing even further despite new technology solutions. Value-based payments are complex and will undoubtedly lead to more denial issues.

Reducing revenue leakage due to denials is usually at the top of every organization’s focus list. Here are three things you can do to better manage your claims process and minimize denials.

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Topics: denial management, revenue cycle management

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