Medical necessity denials continue to be a pain point for revenue cycle leaders, so much so that HBI members reported medical necessity as one of the top three root causes in 2016, 2017, and 2018. While denials and appeals are typically housed within the revenue cycle, there are many other teams—including clinical staff, utilization review, […]
Category: Revenue Cycle
Announcing the 2018 HBI Revenue Cycle Award Winners
We’re thrilled to announce that the winners of HBI’s 2018 Revenue Cycle Study and Awards survey are: Children’s Hospital of Philadelphia Nebraska Medicine Springhill Medical Center While all three have high-performing revenue cycles in common, they represent varied segments of the healthcare landscape. One is a nonprofit, pediatric health system in the East; another is […]
3 Ways Epic Users Tackle Denials
Date:
May 14, 2019
Category:
Revenue Cycle
Earlier this year, HBI hosted a roundtable discussion on analyzing and managing denials. This topic is of constant interest in HBI’s membership community, but best practices often vary by organization. For example, geography and size can shape payer and patient mix, staffing structures, and available technology—ultimately steering how revenue cycle leaders choose to handle denials. […]
Patients Reign Supreme at HBI’s Spring 2019 Member Retreat
HBI held its annual Spring Member Retreat in Boston, Massachusetts, last month (March 25–27)—bringing together approximately 70 revenue cycle professionals from 40+ healthcare organizations. As part of the HBI research team, these events have always been my favorite to not just help coordinate and host, but also to attend. I’m always struck by how kind […]
Federal Government Weighing Stronger Price Transparency Rules
The federal government’s next action to improve price transparency among providers may be requiring organizations to publicize the contracted prices they charge insurance companies for services. A request for comment on this idea and other price transparency initiatives was slipped into a proposal to prevent health information blocking released in February by the Office of […]
How the Revenue Cycle Will Need to Adapt to Value-Based Reimbursement
Value-based payment models are undoubtedly the future of health care. The number of commercial and governmental ACO contracts alone increased by an average of 63% annually from Q1 2011 to Q1 2018, according to a Muhlestein et al. analysis of Leavitt Partners’ data. Though commercial payers have been slower to adopt other models that are […]
The Top Five Challenges Revenue Cycle Leaders Faced in 2018
HBI’s Revenue Cycle Academy received more than 1,300 research requests from the membership community in 2018, allowing us to identify major trends in the issues commanding the attention of leaders throughout the industry. The Top 5 Staff Management: More than a third of the research requests the team received were related to staff management. Revenue […]
Gamification’s Potential in the Revenue Cycle
According to U.S. Census Bureau data, over one third of working Americans are millennials, making them the largest generation in the American workforce. Healthcare organizations have thus turned to efforts to attract and retain millennials, who research indicates may harbor a deeper desire for real-time feedback; a sense of purpose, challenge, and enjoyment in their […]
Pulse Check: Try These Solutions to Avoid Authorization Denials
Date:
January 9, 2019
Category:
Revenue Cycle
Authorization-related denials continue to be among the top denials for organizations. Authorization denials add to A/R days, require work to overturn, and can result in lost revenue. Here’s a list of common pitfalls and possible solutions. We’d love to hear more about your own authorization-related pitfalls and/or solutions your organization is pursing. Reach out to […]