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As healthcare providers navigate the evolving landscape of medical collections, staying informed about emerging trends and potential regulatory changes is crucial. HIPAA: Cybersecurity Focus: With increasing cyber threats, HIPAA may introduce stricter cybersecurity standards to protect patient health information.
Lavaca Medical Center Boosts RevenueCycle Operational Efficiency Amid an EHR Upgrade Home / CLIENT Lavaca Medical Center , located in Hallettsville, Texas , is a full-service critical access hospital delivering imaging, outpatient, skilled nursing, and other healthcare services.
2024 RevenueCycleManagement Challenges and Emerging Trends Home / January 16, 2024 Author: David Mancuso, Sr. Marketing Manager at The SSI Group, LLC Welcome to the healthcare landscape of 2024 – a complex terrain where high stakes meet numerous challenges, defining a dynamic and demanding era in healthcare.
As healthcare continues to evolve, so do the complexities of managing the revenuecycle, with denial management being one of the most persistent challenges. Denial management is an essential component of healthcare revenuecyclemanagement (RCM) because denials directly impact an organization’s financial health.
May 24, 2023 9 Essential Questions RevenueCycle Leaders Should Be Asking About Their Claims and Clearinghouse Partner Welcome to the world of healthcare revenuecyclemanagement, where every aspect of your business is crucial to success.
The Evolution of Electronic Medical Claims and RevenueCycleManagement in the US Healthcare System Home / November 29, 2023 In the constantly evolving landscape of US healthcare, the story of electronic medical claims and revenuecyclemanagement stands out as a testament to technology’s transformative power.
The SSI Group Unveils AI-driven Vision for RevenueCycle Transformation at HFMA Annual Conference 2025 SSI Group unveils AI-driven RCM tools and humanoid at HFMA 2025, advancing automation and predictive analytics in healthcare. hospitals face intense pressure to find new ways to capture greater value.
The Evolution of Medical Billing Clearinghouse Vendors in RevenueCycleManagement: Spotlight on The SSI Group, LLC (SSI) Home / December 20, 2023 Author: Christy Wright, CMO at The SSI Group, LLC In the intricate tapestry of healthcare finance, the journey of a medical claim from inception to resolution is critical.
Hospitals are facing a growing threat to their bottom lines, namely payer requests for information (RFI’s). Cloud-Based Solutions: Consider adopting cloud-based solutions for revenuecyclemanagement. Continuous Learning: Stay updated on industry trends and best practices related to revenuecyclemanagement.
The healthcare revenuecyclemanagement (RCM) domain, a crucial component for any healthcare establishment, has seen seismic shifts since the pandemic. Evolving Needs in the Healthcare RevenueCycleManagement Landscape The ongoing global pandemic has added complexity to an already intricate RCM landscape.
In the complex world of healthcare revenuecyclemanagement, insurance claims and prior authorizations are among the most time-consuming and error-prone processes. Use Cases in Action Automated Claims Submission RPA bots gather billing information, verify coding, and submit claims to payers through clearinghouses or web portals.
Cash Reserves : Maintain a cash reserve to cover unexpected expenses or revenue shortfalls, such as during periods of low occupancy. RevenueCycleManagement : Streamline billing and collections processes to ensure timely payments from residents, insurance companies, and government programs. Access and visibility are key.
Read More The SSI Group Announces Key Partnership with RCxRules The SSI Group, a leader in financial performance solutions for providers and payers, announced today a partnership with RCxRules, a leading provider of automated billing solutions for healthcare organizations’ population health and revenuecycle operations.
May 24, 2023 9 Essential Questions RevenueCycle Leaders Should Be Asking About Their Claims Clearinghouse Vendors Welcome to the world of healthcare revenuecyclemanagement, where every aspect of your business is crucial to success.
For more information on SSI PBE, contact us or request a demo. Click the button below to receive a customized tutorial catered to your specific revenuecyclemanagement (RCM) needs. Reboot Your RevenueCycle with Automated Prior Authorization [HFMA Webinar]. Popular Topics Access Management (1).
Read More The SSI Group Announces Key Partnership with RCxRules The SSI Group, a leader in financial performance solutions for providers and payers, announced today a partnership with RCxRules, a leading provider of automated billing solutions for healthcare organizations’ population health and revenuecycle operations.
Providers will be able to use this API to “determine whether a prior authorization is required, identify prior authorization information and documentation requirements, as well as facilitate the exchange of prior authorization requests and decisions from their electronic health records (EHRs).” billing and claims management (3).
Utilizing machine learning and intelligent automation, SSI Claims Analytics provides access to real-time revenuecycle data along with the ability to transform the data into the insight necessary to significantly simplify the denial management process. Reboot Your RevenueCycle with Automated Prior Authorization [HFMA Webinar].
Eligibility Denials: A Major Challenge for Hospitals March 13, 2023 Denials are one of the most expensive revenuecycle issues, posing major concerns to revenuecycle leaders throughout the country. Problems that lead to denied claims occur throughout the revenuecycle but routinely point to eligibility.
Among them, the 275 electronic attachment is emerging as an essential tool in the realm of RevenueCycleManagement (RCM). Enhanced Security: Electronic attachments have robust security features, protecting patient data and other sensitive information. But why is this important for healthcare providers?
With provider margins razor thin, hospitals and medical groups report continued revenuecycle workforce shortages and increased challenges competing to fill open positions amidst compensation wars. With that experience comes a wealth of claims data that we share with revenuecycle leaders.
Solving the Prior Authorization Dilemma: How Michigan Led the Way and What’s Next [Live Webinar] Join us for an informative webinar to discover how Michigan is revolutionizing the prior authorization process in healthcare. Q&A session to discuss Michigan’s prior authorization process, implementation, and impact on healthcare.
The Dignity Statement: A Beacon of Respect RevCycle, a leader in healthcare revenuecyclemanagement, exemplifies this commitment to respectful language with their innovative “ Dignity Statement.” For more information on this valuable resource, you can contact RevCycle directly.
Together, they’ve implemented a streamlined revenuecyclemanagement solution that fits their current needs and is easily scalable for any future expansion. For more information about The SSI Group’s suite of claims and billing solutions, request a demo. billing and claims management (3). Denial Management (3).
This claim typically includes detailed information about the benefits, associated costs, and relevant patient information. During check-in at a healthcare facility, the patient provides essential personal and insurance information, which includes their name, address, contact details, date of birth, and insurance policy details.
This claim typically includes detailed information about the benefits, associated costs, and relevant patient information. During check-in at a healthcare facility, the patient provides essential personal and insurance information, which includes their name, address, contact details, date of birth, and insurance policy details.
Productivity boost enables you to reallocate staff to more rewarding work, reduce headcount or better manage staffing shortages, improving margins and cutting per patient labor costs. Reduction in the administrative burden on revenuecycle teams in turn leads to improved job satisfaction and employee retention.
With provider margins razor thin, hospitals and medical groups report continued revenuecycle workforce shortages and increased challenges competing to fill open positions amidst compensation wars. With that experience comes a wealth of claims data that we share with revenuecycle leaders.
As revenuecycle leaders and CFOs of hospitals and health systems, you’re at the helm of operational excellence and financial sustainability. The world of revenuecyclemanagement (RCM) is no different. Yet, even amidst this digital transformation, one element remains irreplaceable: the human touch.
With an organization’s significant investment in Epic, one of your top criteria when evaluating claims/clearinghouse vendors should be choosing one that can smoothly integrate with Epic and support your revenuecycle needs downstream. The biller doesn’t have to wait for the nightly claim run or the next day.
This reporting requirement will provide valuable information on the new legislation’s impact and allow for further adjustments to improve the process. This would allow providers to make more informed decisions about treatment options and reduce the uncertainty and delays that can come with the current prior authorization process.
Read More The SSI Group Announces Key Partnership with RCxRules The SSI Group, a leader in financial performance solutions for providers and payers, announced today a partnership with RCxRules, a leading provider of automated billing solutions for healthcare organizations’ population health and revenuecycle operations.
Read More The SSI Group Announces Key Partnership with RCxRules The SSI Group, a leader in financial performance solutions for providers and payers, announced today a partnership with RCxRules, a leading provider of automated billing solutions for healthcare organizations’ population health and revenuecycle operations.
The solution is fully automated and routes payment information in a file format similar to EDI-835, enabling payment reconciliation in real-time with existing software. Click the button below to receive a customized tutorial catered to your specific revenuecyclemanagement (RCM) needs. Denial Management (3).
Automating Prior Authorization Provides Significant Benefits Automation has many benefits – for your patients, workforce, and your revenuecycle. 4 According to the Healthcare Financial Management Association. Now, more than ever, hospitals should consider automating the prior authorization process. 1 CAQH Index 2021.
As revenuecycle leaders and CFOs of hospitals and health systems, you’re at the helm of operational excellence and financial sustainability. The world of revenuecyclemanagement (RCM) is no different. Yet, even amidst this digital transformation, one element remains irreplaceable: the human touch.
Although various methods exist for obtaining claim status information from MACs (Medicare Administrative Contractors), CMS (Centers for Medicare and Medicaid Services) recommends using EDI 276/277 transactions as the preferred method of obtaining claim status.
With an organization’s significant investment in Epic, one of your top criteria when evaluating claims/clearinghouse vendors should be choosing one that can smoothly integrate with Epic and support your revenuecycle needs downstream. The biller doesn’t have to wait for the nightly claim run or the next day.
Among them, the 275 electronic attachment is emerging as an essential tool in the realm of RevenueCycleManagement (RCM). Enhanced Security: Electronic attachments have robust security features, protecting patient data and other sensitive information. But why is this important for healthcare providers?
It involves using software to gather, process and transmit information about the requested medical treatment, insurance coverage and claim information. How do the systems obtain and maintain insurance company authorization contact information? The 278 was a good transaction when it was proposed in the mid-1990s.
As a bridge between healthcare providers and payers, they simplify billing processes, ensure compliance with insurance regulations, and enhance the overall efficiency of revenuecyclemanagement. In response, revenuecycle leaders are increasingly seeking out vendors who simplify enrollment. User Unfriendliness.
Accurate financial reporting and compliance The Role of Order Management in the O2C Process Order management plays a vital role in the order-to-cash (O2C) process, ensuring accurate and timely order fulfillment, which is essential for overall customer satisfaction and revenuecyclemanagement. Effective
Leveraging the Power of Medical Claim Edits: Expediting Payments for Hospitals and Health Systems Home / July 13, 2023 As hospitals and health systems strive to optimize revenuecyclemanagement, the role of edits in streamlining claims processing and expediting payments has become increasingly crucial.
Detailed Financial Reporting and Insights The latest reports and dashboards show you the finances, productivity, and revenuecycle performance, helping you to make data-driven decisions. It assists with the documentation and chores of filing, reimbursements, and gathering payments. It makes your invoice workflow smoother.
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