Hayes' Healthcare Blog

Trouble Ahead: The Unintended Consequences of the Proposed E/M Changes

The provider community has been begging for documentation reform for over 20 years, and there is no question that simplifying the complex requirements of clinical documentation is necessary. Unfortunately, the recent release of the proposed changes from CMS surrounding evaluation and management (E/M) is not the answer. The benefits of the modest reduction in documentation requirements are more than offset by the devastating impact the changes will have operationally, clinically, and financially.

Read More

Topics: Hayes Thought Leadership Blog Series, cms, Revenue, revenue integrity, compliance risk, risk management, Medicare, reporting, clinical documentation, Coding and Documentation

Revenue Integrity Leaders Gather to Find Solutions to Healthcare’s Financial Challenges

Posted by Peter J. Butler on May 2, 2018 at 3:00 PM

By Peter Butler, President and CEO, Hayes Management Consulting

As part of our commitment to helping healthcare organizations optimize their business processes to achieve greater revenue integrity, Hayes has recently formed a Revenue Integrity Advisory Council (RIAC), a small group of revenue cycle and compliance executives who understand the real-world financial challenges associated with running a large, complex organization. We held our first meeting on March 20th in Chicago, where leaders from some of the nation’s most prestigious healthcare organizations gathered for an afternoon to discuss issues, exchange ideas and develop new solutions for overcoming some of their most pressing concerns.

So what was on their minds? Not surprisingly, the topics covered a range of issues including telehealth, quality-based reimbursement, and high-cost drug reimbursement, as well how to organize the coding function and managing compliance issues.

Read More

Topics: Revenue, revenue integrity, Hayes Thought Leadership Blog Series, Thought Leaders

11 Ways to Make Sure Your Contract Management Process is Meeting Your Organization’s Needs

Posted by Margaret Webb-Nolan on April 5, 2018 at 9:00 AM

Managed care contracts make up a significant amount of a healthcare organization’s revenue stream.  The impact these contracts can have on your top and bottom lines makes managing them appropriately one of your top priorities. Those organizations that have realized this and have an effective, efficient contract management process in place have a reasonable upper hand over those that don’t.

Staying on top of your managed care contracts is critical to maintaining a sound financial foundation. Managing these contracts successfully can help drive additional revenue through new insurance products. Properly handled managed care contracts can also increase patient satisfaction by enabling patients to obtain the treatment they need.

If you have challenges in keeping track of and managing your contracts, you are not alone; it is an all too common problem in hospitals and healthcare organizations across the county.

Here are 11 things to consider that can help you develop and administer a successful contract management process.

Read More

Topics: Contract Management, Revenue, Managed Care Contracts

Want more from Hayes?

5 Cool Things in Healthcare

Sign up for our weekly 5 Cool Things in Healthcare newsletter.  Every Friday we give you five stories of innovation, disruption, and - you guessed it - coolness. 

Here's how:

Subscribe to Email Updates

Recent Posts

Posts by Topic

see all