5 steps to improving the claims adjudication process
“Is this claim valid? How much is our financial responsibility?” These are the two big questions payers want to answer when adjudicating healthcare claims. Huge […]
“Is this claim valid? How much is our financial responsibility?” These are the two big questions payers want to answer when adjudicating healthcare claims. Huge […]
With millions of healthcare claims to process and millions of dollars at stake each month, getting claims right the first time is a top performance […]
The repercussions of errors on the healthcare claims processing workflow can be major and wide-ranging. It slows the revenue cycle, interrupts cash flow, consumes staff […]
The payer policy rollercoaster has taken a few twists and turns recently, leaving healthcare organizations out of the loop if they try to keep pace […]
Navigating an increasingly complex reimbursement landscape remains challenging for today’s healthcare providers, with too many claims still underpaid, delayed or outright denied. In fact, nearly […]
The Appropriate Use Criteria (AUC) program is due to come into full effect in January 2023 at the earliest. The program was established by the […]
Claims denials are a major source of headaches for healthcare organizations. On average, denied claims can take more than two weeks longer to pay out […]
In the sixth article in our series on how the patient journey has evolved since the onset of COVID-19, we look at three ways to […]
“Experian Health’s speed and ability to speak our business language definitely impressed us,” said ACS president, Tim Anderson. “Some of the claims were valid for […]
Product featured in this article: Coverage Discovery As of the end of March 2021, more than 53 million Americans have been fully vaccinated, allowing for […]
Many thought the end of COVID-19 was in sight with the availability of a vaccine, and while that is somewhat true, an entirely new set […]
There is no question that providers’ bottom line has been hit hard this year, and a new surge in COVID-19 is bound to threaten hospital […]
Claims denials put a big dent into the budgets of healthcare providers – something many organizations can’t afford today given the current pandemic. In an […]
As every healthcare executive knows, a healthy revenue cycle relies on precise paperwork. That’s why all Medicare providers should be paying close attention to the […]
Halloween is just around the corner, and while the holiday and celebration may look a little different this year (no thanks to COVID-19), the excitement […]
Financial recovery after COVID-19 is likely to be a slow burn for most healthcare organizations, according to a recent survey. Nearly 90% of healthcare executives […]
With COVID-19 leading to postponed and cancelled medical appointments, more consumers are turning to “contactless care”. Recent figures suggest telehealth adoption has shot up from […]
Patients today expect digital capabilities from their provider and will increasingly choose those who offer digital capabilities. Knowing this, many providers have been working to […]
At the beginning of the year, the healthcare industry moved away from Medicare identifiers based on Social Security Numbers (SSNs), in favor of more secure […]
For many of the 36 million Americans who have registered for unemployment benefits during the coronavirus outbreak, losing their job means losing their health insurance. […]
There’s a phenomenon in online product reviews where the customer seems to love their purchase, yet gives it only one or two stars. Why do […]
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