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| benefits of revenue cycle management: Medical Revenue Cycle Management - The Comprehensive Guide VIRUTI SATYAN SHIVAN, This essential guide dives deep into the intricacies of Medical Revenue Cycle Management (MRCM), offering healthcare professionals, administrators, and students a clear roadmap to mastering the financial backbone of healthcare services. In a landscape where financial health is as critical as patient health, this book stands out by providing a meticulously researched, expertly written exploration of every phase of the revenue cycle—from patient registration to the final payment of balances. Without relying on images or illustrations, we navigate through complex regulations, coding challenges, and billing practices with clarity and precision, making this complex subject accessible and actionable. Our unique approach combines theoretical frameworks with practical, real-world applications, setting this book apart as a must-buy. We delve into innovative strategies for optimizing revenue, reducing denials, and enhancing patient satisfaction, all while maintaining compliance with evolving healthcare laws and regulations. By focusing on efficiency and effectiveness, we equip readers with the tools and insights needed to transform their revenue cycle processes. Whether you're looking to refine your current practices or build a foundation of knowledge from the ground up, this guide offers invaluable insights into achieving financial stability and success in the ever-changing world of healthcare. |
| benefits of revenue cycle management: Core Functions of Revenue Integrity Valerie A. Rinkle, 2017 |
| benefits of revenue cycle management: Principles of Healthcare Reimbursement and Revenue Cycle Management, Eighth Edition Anne Casto, Susan White, 2023-10-02 |
| benefits of revenue cycle management: Revenue Cycle Management HCPro (Firm), 2006 |
| benefits of revenue cycle management: DRG Expert Ingenix, 2010-09 THE DRG EXPERT has been a trusted and comprehensive reference to the DRG classification system for over 25 years. Organized by major diagnostic category (MDC), the convenient and innovative book layout follows the logical MS-DRG decision process. This is a must-have reference for those who need to verify DRG information and accurately assign MS-DRGs concurrently or retrospectively. |
| benefits of revenue cycle management: The Business Basics of Building and Managing a Healthcare Practice Neil Baum, Marc J. Kahn, 2019-11-20 This book is intended to be a roadmap towards a successful practice for medical students, residents, fellows, and doctors. This roadmap focuses on how to build and manage a medical practice, and can be applied regardless if the reader is employed, joins a small group, or if they are a doctor who decides to start their own practice. Part I covers the basic business concepts that every physician needs to know. Chapters emphasize the benefits that accrue to a physician who understands the basics of business. Part II provides a guide for doctors who are beginning a medical practice. The chapters define the various options for doctors’ employment such as solo practice, group practice, and academic medicine. The section also includes the process of negotiating contracts, identifying the advisers who help physicians become successful, and secure within their field and practice. The final part emphasizes strategies on how to build and grow a successful practice by covering topics such as hiring staff, employee motivation, creating a brand, gaining recognition, online reputation and presence, crisis management, integrating new technology, and work/life balance. The Business Basics of Building and Managing a Healthcare Practice serves as a valuable resource that helps doctors make a difference in the lives of their patients, as well as help them make good financial decisions. |
| benefits of revenue cycle management: The Medical-Legal Aspects of Acute Care Medicine James E. Szalados, 2021-04-02 The Medical-Legal Aspects of Acute Care Medicine: A Resource for Clinicians, Administrators, and Risk Managers is a comprehensive resource intended to provide a state-of-the-art overview of complex ethical, regulatory, and legal issues of importance to clinical healthcare professionals in the area of acute care medicine; including, for example, physicians, advanced practice providers, nurses, pharmacists, social workers, and care managers. In addition, this book also covers key legal and regulatory issues relevant to non-clinicians, such as hospital and practice administrators; department heads, educators, and risk managers. This text reviews traditional and emerging areas of ethical and legal controversies in healthcare such as resuscitation; mass-casualty event response and triage; patient autonomy and shared decision-making; medical research and teaching; ethical and legal issues in the care of the mental health patient; and, medical record documentation and confidentiality. Furthermore, this volume includes chapters dedicated to critically important topics, such as team leadership, the team model of clinical care, drug and device regulation, professional negligence, clinical education, the law of corporations, tele-medicine and e-health, medical errors and the culture of safety, regulatory compliance, the regulation of clinical laboratories, the law of insurance, and a practical overview of claims management and billing. Authored by experts in the field, The Medical-Legal Aspects of Acute Care Medicine: A Resource for Clinicians, Administrators, and Risk Managers is a valuable resource for all clinical and non-clinical healthcare professionals. |
| benefits of revenue cycle management: Roadmaps to Value-Based Profitability Jennifer Ternay, 2019 What does it mean to shift value-based payment models? Maybe you aren't sure where to start. How can you stay competitive amidst the changes in healthcare when resources are limited? While reading this book, you will dive deeply into the key challenges and opportunities of value-based care. We will explore how you can use your core values and strengths to transform your practice-driving away from maximizing volume with fee-for-service billing to reimbursement under incentive programs that are part of value-based payments. By answering critical questions such as where to start, what the finish line looks like, and what happens along the way you will gain the insight needed to deliver a better patient experience while improving health and lowering the cost of care. Learn to: Support your practice's transformation by understanding the leadership skills needed to succeed in value-based incentive programs; evaluate what already exists in your practice and what needs to change to succeed in demonstrating outcomes; determine key elements to assess when considering options for participating in programs with alternative payment models; examine how the organization of teams can deliver better patient experience and higher staff satisfaction; determine how to create a high-functioning team based on each person's strengths; analyze the behavioral traits of team members to maximize their potential and improve retention. Across the healthcare industry, the push is to deliver value rather than volume with value-based payment programs being the financing mechanism to drive change. This book is the perfect starting point to gather information about how to prepare for and maximize, your participation in value-based payment models. You will learn to create the foundation to evaluate value-based payment models and understand how your practice needs to be structured to succeed in value-based care and avoid penalties or exclusion from networks. Reading this book, you will gain insights from a managed care perspective and walk away with recommendations to implement in your practice-- |
| benefits of revenue cycle management: Coverage Matters Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance, 2001-10-27 Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers. |
| benefits of revenue cycle management: The Complete Business Guide for a Successful Medical Practice Neil Baum, Roger G. Bonds, Thomas Crawford, Karl J. Kreder, Koushik Shaw, Thomas Stringer, Raju Thomas, 2015-01-02 This text provides physicians with the basic business skills in order for them to become involved in the financial aspect of their practices. The text will help the physician decide what kind of practice they would like to join (i.e. private practice, small group practice, solo practice, hospital employment, large group practice, academic medicine, or institutional\government practice) as well as understand the basics of contracting, restrictive covenants and how to navigate the road to partnership. Additional topics covered include, monthly balance sheets, productivity, overhead costs and profits, trend analysis and benchmarking. Finally, the book provides advice on advisors that doctors will need to help with the business of their professional and personal lives. These include accountants, bankers, lawyers, insurance agents and other financial advisors. The Complete Business Guide for a Successful Medical Practice provides a roadmap for physicians to be not only good clinical doctors but also good businessmen and businesswomen. It will help doctors make a difference in the lives of their patients as well as sound financial decisions for their practice. |
| benefits of revenue cycle management: Revenue Cycle Management Kem Tolliver, Shawntea Moheiser, 2020-04-16 It is easy to get lost in all the phases of revenue management, so how does a practice keep it all straight? Proven solutions to optimize revenue cycle are the key, and this primer is a business-critical resource to deliver just that. |
| benefits of revenue cycle management: Engineering a Learning Healthcare System National Academy of Engineering, Institute of Medicine, 2011-07-14 Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system. |
| benefits of revenue cycle management: Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies OECD, World Health Organization, 2019-10-17 This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies. |
| benefits of revenue cycle management: The Hospital Guide to Contemporary Utilization Review Stefani Daniels, Ronald L Hirsch, MD, Facp, Chcqm, Ronald L. Hirsch, 2015-04-16 The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives |
| benefits of revenue cycle management: Costs and Benefits of Health Information Technology Paul G. Shekelle, Caroline Lubick Goldzweig, 2009 This report aims to gather the lessons learnt on the effects of HIT to costs and benefits that might be of use to organisations looking to develop and implement HIT programmes. This is a difficult exercise considering the multiple factors affecting implementation of an HIT programme. Factors include organisational characteristics, the kinds of changes being put in place and how they are managed, and the type of HIT system. The report finds that barriers to HIT implementation are still substantial but that some progress has been made on reporting the organisational factors crucial for the adoption of HIT. However, there is a challenge to adapt the studies and publications from HIT leaders (early implementers and people using HIT to best effect) to offer lessons beyond their local circumstances. The report also finds limited data on the cost-effectiveness of HIT. |
| benefits of revenue cycle management: Crossing the Quality Chasm Institute of Medicine, Committee on Quality of Health Care in America, 2001-07-19 Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change. |
| benefits of revenue cycle management: Revenue Cycle Management ABA Therapy Michele Silcox, Sarah Schmitz, 2020-08 A journey through the revenue cycle to help your practice thrive!The Revenue Cycle affects every aspect of the financial success of your practice and the delivery of care. Using the information in this book you will have measurements of progress in your practice for the revenue cycle and the ability to identify shortfalls. A step by step comprehensive review of each step of the cycle will bridge gaps between tactical and communication efforts with clinical and administrative functions. |
| benefits of revenue cycle management: Denial Management Pam Waymack, 2005 |
| benefits of revenue cycle management: Hospital Reimbursement Kyle Herbert, 2012-06-05 Due to the countless variables that affect revenue and cost, the hospital reimbursement process is by far the most complex of any industry. Requiring only a basic financial background and a working knowledge of accounting, Hospital Reimbursement: Concepts and Principles supplies a clear understanding of the concepts and principles that drive the revenue cycle within a hospital setting. The book explains the technical aspects of reimbursement in language that is easy to comprehend. It illustrates the complexities of the hospital revenue cycle and explains the Medicare and Medicaid financial models in detail. The text also addresses the Medicaid reimbursement methodology, the formulation of the Medicare blend rate, the computation of both DSH and IME, as well as other third-party payers. It also: Covers the full range of services and procedures for which a hospital can receive reimbursement Explains the difference between a for-profit and not-for-profit hospital Contains chapters devoted to Statements of Operations (Income Statement) and Statements of Financial Position (Balance Sheet) Examines governmental cost reporting—including Worksheets A, A-6, A-8, A-8-2, B-1, B Part 1, C Part 1, D-3, D-5, and E Part A Supplying readers with a foundation in coding principles, the text also includes a model for calculating the financial impact of variations in patient length of stay. It discusses the DRG and APC reimbursement models and details the computation of an outlier payment. In addition, it walks the reader step-by-step through the creation of a mock Medicare cost report for a sample hospital. |
| benefits of revenue cycle management: Infonomics Douglas B. Laney, 2017-09-05 Many senior executives talk about information as one of their most important assets, but few behave as if it is. They report to the board on the health of their workforce, their financials, their customers, and their partnerships, but rarely the health of their information assets. Corporations typically exhibit greater discipline in tracking and accounting for their office furniture than their data. Infonomics is the theory, study, and discipline of asserting economic significance to information. It strives to apply both economic and asset management principles and practices to the valuation, handling, and deployment of information assets. This book specifically shows: CEOs and business leaders how to more fully wield information as a corporate asset CIOs how to improve the flow and accessibility of information CFOs how to help their organizations measure the actual and latent value in their information assets. More directly, this book is for the burgeoning force of chief data officers (CDOs) and other information and analytics leaders in their valiant struggle to help their organizations become more infosavvy. Author Douglas Laney has spent years researching and developing Infonomics and advising organizations on the infinite opportunities to monetize, manage, and measure information. This book delivers a set of new ideas, frameworks, evidence, and even approaches adapted from other disciplines on how to administer, wield, and understand the value of information. Infonomics can help organizations not only to better develop, sell, and market their offerings, but to transform their organizations altogether. Doug Laney masterfully weaves together a collection of great examples with a solid framework to guide readers on how to gain competitive advantage through what he labels the unruly asset – data. The framework is comprehensive, the advice practical and the success stories global and across industries and applications. Liz Rowe, Chief Data Officer, State of New Jersey A must read for anybody who wants to survive in a data centric world. Shaun Adams, Head of Data Science, Betterbathrooms.com Phenomenal! An absolute must read for data practitioners, business leaders and technology strategists. Doug's lucid style has a set a new standard in providing intelligible material in the field of information economics. His passion and knowledge on the subject exudes thru his literature and inspires individuals like me. Ruchi Rajasekhar, Principal Data Architect, MISO Energy I highly recommend Infonomics to all aspiring analytics leaders. Doug Laney’s work gives readers a deeper understanding of how and why information should be monetized and managed as an enterprise asset. Laney’s assertion that accounting should recognize information as a capital asset is quite convincing and one I agree with. Infonomics enjoyably echoes that sentiment! Matt Green, independent business analytics consultant, Atlanta area If you care about the digital economy, and you should, read this book. Tanya Shuckhart, Analyst Relations Lead, IRI Worldwide |
| benefits of revenue cycle management: Ask a Manager Alison Green, 2018-05-01 From the creator of the popular website Ask a Manager and New York’s work-advice columnist comes a witty, practical guide to 200 difficult professional conversations—featuring all-new advice! There’s a reason Alison Green has been called “the Dear Abby of the work world.” Ten years as a workplace-advice columnist have taught her that people avoid awkward conversations in the office because they simply don’t know what to say. Thankfully, Green does—and in this incredibly helpful book, she tackles the tough discussions you may need to have during your career. You’ll learn what to say when • coworkers push their work on you—then take credit for it • you accidentally trash-talk someone in an email then hit “reply all” • you’re being micromanaged—or not being managed at all • you catch a colleague in a lie • your boss seems unhappy with your work • your cubemate’s loud speakerphone is making you homicidal • you got drunk at the holiday party Praise for Ask a Manager “A must-read for anyone who works . . . [Alison Green’s] advice boils down to the idea that you should be professional (even when others are not) and that communicating in a straightforward manner with candor and kindness will get you far, no matter where you work.”—Booklist (starred review) “The author’s friendly, warm, no-nonsense writing is a pleasure to read, and her advice can be widely applied to relationships in all areas of readers’ lives. Ideal for anyone new to the job market or new to management, or anyone hoping to improve their work experience.”—Library Journal (starred review) “I am a huge fan of Alison Green’s Ask a Manager column. This book is even better. It teaches us how to deal with many of the most vexing big and little problems in our workplaces—and to do so with grace, confidence, and a sense of humor.”—Robert Sutton, Stanford professor and author of The No Asshole Rule and The Asshole Survival Guide “Ask a Manager is the ultimate playbook for navigating the traditional workforce in a diplomatic but firm way.”—Erin Lowry, author of Broke Millennial: Stop Scraping By and Get Your Financial Life Together |
| benefits of revenue cycle management: Reliability Centered Maintenance (RCM) Neil B. Bloom, 2005-12-22 A properly implemented and managed RCM program can save millions in unscheduled maintenance and breakdowns. However, many have found the process daunting. Written by an expert with over 30 years of experience, this book introduces innovative approaches to simplify the RCM process such as: single vs. multiple failure analysis, hidden failures analysis, potentially critical components analysis, run-to-failure and the difference between redundant, standby, and backup functions. Included are real life examples of flawed preventive maintenance programs and how they led to disasters that could have easily been avoided. Also illustrated in detail, with real-life examples, is the step-by-step process for developing, implementing, and maintaining a premier classical RCM program. Senior management, middle management, supervisors, and craftsmen/technicians responsible for plant safety and reliability will find this book to be invaluable as a means for establishing a first class preventive maintenance program. |
| benefits of revenue cycle management: The Culture Cycle James L. Heskett, 2012 The contribution of culture to organizational performance is substantial and quantifiable. In The Culture Cycle, renowned thought leader James Heskett demonstrates how an effective culture can account for 20-30% of the differential in performance compared with culturally unremarkable competitors. Drawing on decades of field research and dozens of case studies, Heskett introduces a powerful conceptual framework for managing culture, and shows it at work in a real-world setting. Heskett's culture cycle identifies cause-and-effect relationships that are crucial to shaping effective cultures, and demonstrates how to calculate culture's economic value through Four Rs: referrals, retention, returns to labor, and relationships. This book: Explains how culture evolves, can be shaped and sustained, and serve as the organization's internal brand. Shows how culture can promote innovation and survival in tough times. Guides leaders in linking culture to strategy and managing forces that challenge it. Shows how to credibly quantify culture's impact on performance, productivity, and profits. Clarifies culture's unique role in mission-driven organizations. A follow-up to the classic Corporate Culture and Performance (authored by Heskett and John Kotter), this is the next indispensable book on organizational culture. Heskett (emer., Harvard Business School) provides an exhaustive examination of corporate policies, practices, and behaviors in organizations. Summing Up: Recommended. Reprinted with permission from CHOICE, copyright by the American Library Association. |
| benefits of revenue cycle management: Health Care Administration Lawrence F. Wolper, 2004 Health Care Administration continues to be the definitive guide to contemporary health administration and is a must-have reference for students and professionals. This classic text provides comprehensive coverage of detailed functional, technical, and organizational matters. |
| benefits of revenue cycle management: Smartsourcing Thomas M Koulopoulos, Tom Roloff, 2006-02-24 Outsourcing is the most popular movement of the new global business economy. In fact, the typical executive will soon spend one-third of their budget on outsourcing! Smartsourcing is the next evolution in outsourcing. Traditional outsourcing reduces costs by moving the work to where the least expensive workers are. While that may cut costs, it simply replicates the status quo. Smartsourcing goes a step further by showing companies how to partner with service providers to not only cut costs, but also increase innovation across the full spectrum of their business. Smartsourcing is the first book on the market to be ahead of the curve on one of the most important shifts in business today. |
| benefits of revenue cycle management: Evidence-Based Medicine and the Changing Nature of Health Care Institute of Medicine, LeighAnne M. Olsen, Elizabeth G. Nabel, J. Michael McGinnis, Mark B. McClellan, 2008-09-06 Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership. |
| benefits of revenue cycle management: Financial Management of Health Care Organizations William N. Zelman, Michael J. McCue, Noah D. Glick, 2009-09-15 Thoroughly revised, this third edition of Financial Management of Health Care Organizations offers an introduction to the most-used tools and techniques of health care financial management. Comprehensive in scope, the book covers a broad range of topics that include an overview of the health care system and evolving reimbursement methodologies; health care accounting and financial statements; managing cash, billings, and collections; the time value of money and analyzing and financing major capital investments; determining cost and using cost information in decision-making; budgeting and performance measurement; and pricing. In addition, this new edition includes information on new laws and regulations that affect health care financial reporting and performance, revenue cycle management expansion of health care services into new arenas, benchmarking, interest rate swaps, bond ratings, auditing, and internal control. This important resource also contains information on the 2007 Healthcare Audit Guide of the American Institute of Certified Public Accountants (AICPA). Written to be accessible, the book avoids complicated formulas. Chapter appendices offer advanced, in-depth information on the subject matter. Each chapter provides a detailed outline, a summary, and key terms, and includes problems in the context of real-world situations and events that clearly illustrate the concepts presented. Problem sets that end each chapter have been updated and expanded to support more in-depth learning of the chapters’ concepts. An Instructor’s Manual, available online, contains PowerPoint and Excel files. |
| benefits of revenue cycle management: Health-Care Utilization as a Proxy in Disability Determination National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Care Services, Committee on Health Care Utilization and Adults with Disabilities, 2018-04-02 The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for listing-level severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience. |
| benefits of revenue cycle management: Artificial Intelligence in Healthcare Adam Bohr, Kaveh Memarzadeh, 2020-06-21 Artificial Intelligence (AI) in Healthcare is more than a comprehensive introduction to artificial intelligence as a tool in the generation and analysis of healthcare data. The book is split into two sections where the first section describes the current healthcare challenges and the rise of AI in this arena. The ten following chapters are written by specialists in each area, covering the whole healthcare ecosystem. First, the AI applications in drug design and drug development are presented followed by its applications in the field of cancer diagnostics, treatment and medical imaging. Subsequently, the application of AI in medical devices and surgery are covered as well as remote patient monitoring. Finally, the book dives into the topics of security, privacy, information sharing, health insurances and legal aspects of AI in healthcare. - Highlights different data techniques in healthcare data analysis, including machine learning and data mining - Illustrates different applications and challenges across the design, implementation and management of intelligent systems and healthcare data networks - Includes applications and case studies across all areas of AI in healthcare data |
| benefits of revenue cycle management: SAP Billing and Revenue Innovation Management Chaitanaya Desai, Sheikna Kulam, Chun Wei Ooi, Maniprakash Balasubramanian, Clement Sanjivi, Andreas Tan, Rakesh Rajagopal, 2019 Whether you're upgrading an existing billing system or moving to a subscription- or consumption-based model, SAP BRIM is ready--and here's is your guide! From subscription order management and charging to invoicing and contract accounting, get step-by-step instructions for each piece of the billing puzzle. For setup, execution, or analytics, follow a continuous case study through each billing process. With this book, join the future of billing! a. End-to-End Billing Learn the what and the why of SAP BRIM, and then master the how! Charging, invoicing, contract accounts receivable and payable, and subscription order management--see how to streamline billing with the SAP BRIM solutions. b. Configuration and Functionality Set up and use SAP BRIM tools: Subscription Order Management, SAP Convergent Charging, SAP Convergent Invoicing, FI-CA, and more. Implement them individually or as part of an integrated landscape. c. SAP BRIM in Action Meet Martex Corp., a fictional telecommunications case study and your guide through the SAP BRIM suite. Follow its path to subscription-based billing and learn from billing industry best practices! 1) SAP Billing and Revenue Innovation Management 2) Subscription order management 3) SAP Convergent Charging 4) SAP Convergent Invoicing 5) Contracts accounting (FI-CA) 6) SAP Convergent Mediation 7) Reporting and analytics 8) Implementation 9) Project management |
| benefits of revenue cycle management: The Healthcare Imperative Institute of Medicine, Roundtable on Evidence-Based Medicine, 2011-01-17 The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers. |
| benefits of revenue cycle management: Health Professions Education Institute of Medicine, Board on Health Care Services, Committee on the Health Professions Education Summit, 2003-07-01 The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system. |
| benefits of revenue cycle management: SPIN® -Selling Neil Rackham, 2020-04-28 True or false? In selling high-value products or services: 'closing' increases your chance of success; it is essential to describe the benefits of your product or service to the customer; objection handling is an important skill; open questions are more effective than closed questions. All false, says this provocative book. Neil Rackham and his team studied more than 35,000 sales calls made by 10,000 sales people in 23 countries over 12 years. Their findings revealed that many of the methods developed for selling low-value goods just don‘t work for major sales. Rackham went on to introduce his SPIN-Selling method. SPIN describes the whole selling process: Situation questions Problem questions Implication questions Need-payoff questions SPIN-Selling provides you with a set of simple and practical techniques which have been tried in many of today‘s leading companies with dramatic improvements to their sales performance. |
| benefits of revenue cycle management: A Step-By-Step on Doubling the Value of Your Practice Without Seeing More Patients Hernan Rizo, Walter C. Wilson, Esq., 2021-08-05 A Step-by-Step on Doubling the Value of Your Practice Without Seeing More Patients – A Guide to Modern Practice Management- has everything you need to know to navigate your physician and dental career through today’s unparalleled business environment. Even after the pandemic, even after the harsh financial conditions some private practitioners have gone through lately, I can assure you, this is the most exciting and profitable time to be in private practice. You’ll learn how to increase profitability in your practice, enhance revenues, cut costs, optimize operations, all out of your current book of business. You’ll also learn how to value and groom your practice for sale and how to turn the tables on DSO’s and Private Equity Groups allowing you to keep most of the final, realized value of your practice. This is the culmination of 20 years of the CFO Group’s experience working with private practitioners. |
| benefits of revenue cycle management: The Pig Book Citizens Against Government Waste, 2013-09-17 The federal government wastes your tax dollars worse than a drunken sailor on shore leave. The 1984 Grace Commission uncovered that the Department of Defense spent $640 for a toilet seat and $436 for a hammer. Twenty years later things weren't much better. In 2004, Congress spent a record-breaking $22.9 billion dollars of your money on 10,656 of their pork-barrel projects. The war on terror has a lot to do with the record $413 billion in deficit spending, but it's also the result of pork over the last 18 years the likes of: - $50 million for an indoor rain forest in Iowa - $102 million to study screwworms which were long ago eradicated from American soil - $273,000 to combat goth culture in Missouri - $2.2 million to renovate the North Pole (Lucky for Santa!) - $50,000 for a tattoo removal program in California - $1 million for ornamental fish research Funny in some instances and jaw-droppingly stupid and wasteful in others, The Pig Book proves one thing about Capitol Hill: pork is king! |
| benefits of revenue cycle management: The Future of the Public's Health in the 21st Century Institute of Medicine, Board on Health Promotion and Disease Prevention, Committee on Assuring the Health of the Public in the 21st Century, 2003-02-01 The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists. |
| benefits of revenue cycle management: Revenue Management Robert G. Cross, 2011-04-27 From the man the Wall Street Journal hailed as the guru of Revenue Management comes revolutionary ways to recover from the after effects of downsizing and refocus your business on growth. Whatever happened to growth? In Revenue Management, Robert G. Cross answers this question with his ground-breaking approach to revitalizing businesses: focusing on the revenue side of the ledger instead of the cost side. The antithesis of slash-and-burn methods that left companies with empty profits and dissatisfied stockholders, Revenue Management overturns conventional thinking on marketing strategies and offers the key to initiating and sustaining growth. Using case studies from a variety of industries, small businesses, and nonprofit organizations, Cross describes no-tech, low-tech, and high-tech methods that managers can use to increase revenue without increasing products or promotions; predict consumer behavior; tap into new markets; and deliver products and services to customers effectively and efficiently. His proven tactics will help any business dramatically improve its bottom line by meeting the challenge of matching supply with demand. |
| benefits of revenue cycle management: Back to Balance Halee Fischer-Wright, 2017-09 Dr. Halee Fischer-Wright presents a unique prescription for fixing America's health care woes, based on her thirty years of experience as a physician and industry leader.-- |
| benefits of revenue cycle management: Health Care Finance and the Mechanics of Insurance and Reimbursement Michael K. Harrington, 2023-07 Health Care Finance and the Mechanics of Insurance and Reimbursement combines financial principles unique to the health care setting with the methods and process for reimbursement (including coding, reimbursement strategies, compliance, financial reporting, case mix index, and external auditing). It explains the revenue cycle, correlating it with regular management functions; and covers reimbursement from the initial point of care through claim submission and reconciliation. Updated throughout the Third Edition offers expanded material on financial statements; new and expanded Skilled Nursing Facility examples; and enhanced sections on PDPM, Practice Management for Primary Care and other Specialties, Clearinghouse Processes, Predictive Modeling (data mining), and more. Key Features: - Thoroughly covers the methods and process for reimbursement including coding, reimbursement strategies, compliance, financial reporting, case mix index, and external auditing - Prepares health administration and health information management students with the necessary tools to successfully transition from the classroom to the health care facility. - Addresses all the new characteristics of the accounting authorities that the health care administrator will have to deal with after the COVID-19 Pandemic. - Includes a full chapter on the ACA that addresses recent and anticipated future changes that could impact not only the patient but the various health care organizations that provide care in the inpatient and outpatient settings. |
| benefits of revenue cycle management: Benchmarking Success Gregory Feltenberger, David Gans, 2017-09-18 A practice's long-term success is directly related to its ability to identify, predict, and adjust for changes. Benchmarking, when used properly, is the best tool for overcoming these challenges. |
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