Effective Revenue Cycle Management

  effective 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.
  effective revenue cycle management: Reinventing Revenue Cycle Management April Wilson, Casey Williams, Marty Callahan, 2018-06-08 While the industry continues to undergo growing pains, transitioning to value-based care from fee-for-service, hospitals and providers are also fielding new challenges that have emerged on the regulatory, technology, and patient-consumer fronts. Hospitals and providers are in a race against one another to find new ways to attract and retain patients. Now that patients are assuming greater financial responsibility for their healthcare costs, whether voluntarily or involuntarily, their expectations are high about having a positive clinical and financial experience. Therefore, the engagement of patients should begin before the actual clinical encounter. The RCM departments of forward-thinking organizations recognize that an active patient engagement strategy is an effective way of influencing positive patient payment behaviors.Revenue cycle plays an intrinsic role in the overall patient experience, and there are multiple touchpoints by which to engage patients before billing them. Some examples include being transparent with patients at the outset about their financial obligations, removing barriers to payment by providing flexible options and payment tools, such as an online payment portal, and enhancing the design of billing statements. Patient engagement that prioritizes consumer satisfaction can lead to good financial outcomes for healthcare organizations.This book will help RCM professionals navigate the changing environment successfully.
  effective 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.
  effective revenue cycle management: Theory and Practice of Business Intelligence in Healthcare Khuntia, Jiban, Ning, Xue, Tanniru, Mohan, 2019-12-27 Business intelligence supports managers in enterprises to make informed business decisions in various levels and domains such as in healthcare. These technologies can handle large structured and unstructured data (big data) in the healthcare industry. Because of the complex nature of healthcare data and the significant impact of healthcare data analysis, it is important to understand both the theories and practices of business intelligence in healthcare. Theory and Practice of Business Intelligence in Healthcare is a collection of innovative research that introduces data mining, modeling, and analytic techniques to health and healthcare data; articulates the value of big volumes of data to health and healthcare; evaluates business intelligence tools; and explores business intelligence use and applications in healthcare. While highlighting topics including digital health, operations intelligence, and patient empowerment, this book is ideally designed for healthcare professionals, IT consultants, hospital directors, data management staff, data analysts, hospital administrators, executives, managers, academicians, students, and researchers seeking current research on the digitization of health records and health systems integration.
  effective 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.
  effective revenue cycle management: Principles of Healthcare Reimbursement and Revenue Cycle Management, Eighth Edition Anne Casto, Susan White, 2023-10-02
  effective revenue cycle management: Denial Management Pam Waymack, 2005
  effective revenue cycle management: Revenue Cycle Management HCPro (Firm), 2006
  effective revenue cycle management: Revenue Operations Stephen G. Diorio, Chris K. Hummel, 2022-04-19 Crush siloes by connecting teams, data, and technologies with a new systems-based approach to growth. Growing a business in the 21st Century has become a capital intensive and data-driven team sport. In Revenue Operations: A New Way to Align Sales and Marketing, Monetize Data, and Ignite Growth, an accomplished team of practitioners, academics, and experts provide a proven system for aligning revenue teams and unlocking growth. The book shows everyone how to connect the dots across an increasingly complex technology ecosystem to simplify selling and accelerate revenue expansion. With Revenue Operations, you’ll understand what it takes to successfully transition to the new system of growth without killing your existing business. This practical and executable approach can be used by virtually any business - large or small, regardless of history or industry - that wants to generate more growth and value. By reading this book you will find: Real-world case studies and personal experiences from executives across an array of high technology, commercial, industrial, services, consumer, and cloud-based businesses. The six core elements of a system for managing your commercial operations, digital selling infrastructure, and customer data assets. Nine building-blocks that connect the dots across your sales and marketing technology ecosystem to generate more consistent growth and a better customer experience at lower costs. The skills and tools that next generation growth leaders will need to chart the roadmap for a successful career in any growth discipline for the next 25 years. An indispensable resource for anyone who wants to get more from their business – board members, CEOs, business unit leaders, strategists, thought leaders, analysts, operations professionals, partners, and front-line doers in sales, marketing, and service - Revenue Operations is based on over one thousand surveys of and interviews with business professionals conducted during 2020 and 2021. It also includes a comprehensive analysis of the sales and marketing technology landscape. As a perfectly balanced combination of academic insight and data-driven application, this book belongs on the bookshelves of anyone responsible for driving revenue and growth.
  effective revenue cycle management: Denials Management & Appeals Reference Guide - First Edition AAPC, 2020-03-17 Recoup lost time and revenue with denials management and appeals know-how. Claim denials can sink a profit margin. And given the cost of appeals, roughly $118 per claim, not all denials can be reworked. A practice submitting 50 claims a day at an average reimbursement rate of $200 per claim should bring in $10,000 in daily revenue. But if 10% of those claims are denied, and the practice can only appeal one, they lose $800 per day—upwards of $200K annually. Your medical claims are the lifeblood of operations. Don’t compromise your financial health. Learn how to preempt denials with the Denials Management & Appeals Reference Guide. This vital resource will equip you to get ahead of payers by simplifying the leading causes of denials and showing you how to address insufficient documentation, failing to establish medical necessity, coding and billing errors, coverage stipulations, and untimely filing. Rely on AAPC to walk you through the appeal process. We’ll help you establish protocols to avoid an appeals backlog and teach you how to identify and prioritize denials likely to win an appeal. What’s more, you’ll learn when a claim can be “reopened” to fix a problem. Collect the revenue your practice deserves with effective denials and appeals solutions: Know how to analyze your denials Defeat documentation and compliance issues for successful claims success Utilize payer policy for coverage clues Lock in revenue with face-to-face reimbursement guidance Refine efforts to avoid E/M claim denials Ace ICD-10 coding for optimum reimbursement Put an end to modifier confusion Stave off denials with CCI edits advice Navigate the appeals process like a pro And much more!
  effective 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.
  effective 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.
  effective 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.
  effective revenue cycle management: The Denials Management Training Handbook Tanja Twist, 2017-01-17 The Denials Management Training Handbook (Pack of 5) Tanja Twist, MBA/HCM Many hospitals struggle with denials management thanks to the complex regulations and various types of denials. Payers often send denials to the wrong person, and hospitals may lose valuable research and appeals time as a result. In addition, drafting effective appeals letters that follow Medicare's regulations can be time-consuming and difficult even for experienced staff. Worst of all, the hard work of managing denials and submitting appeals on the back end can all be wasted if there is no system to use denials data to address root causes on the front end. The Denials Management Training Handbook provides clear, concise explanations of the complex appeal guidelines for Medicare and other payers. This information is presented in an easy-to-understand handbook for distribution to staff members involved in preventing and handling appeals. This handbook will help you manage the denials management process by: Providing an overview of common denial types and appeal timelines Giving you sample forms and templates Exploring best practices for improving the denials management process throughout the revenue cycle Gliding in the use of denials data to track recurrent denials and address their causes
  effective revenue cycle management: The Chargemaster Essentials Toolkit Valerie A. Rinkle, 2016-12-19
  effective revenue cycle management: Health Services Management Zachary Pruitt, PhD, MHA, FACHE, 2024-11-15 Health Services Management: Competencies and Careers provides students in healthcare administration and management, public health, and other healthcare sectors with the necessary knowledge, practical understanding, and fundamental skills to become successful, confident, and empathetic health services managers in this exciting and growing field. The text incorporates fundamental management competencies in every chapter and supplies relevant examples of managerial decision-making and problem-solving in various health service delivery settings. Written with Generation Z students in mind, this book takes on a straightforward approach to planning, organizing, directing, and leading, and imparts important knowledge on the science of evidence-based management. Health Services Management covers the roles and functions of health services managers and breaks down the variety of subjects they must understand to be thoughtful and effective. Chapters cover the dynamic challenges in managing interpersonal relationships, navigating leadership and change, and balancing professionalism and ethics to prepare future leaders for the obstacles ahead. Students are also given a better understanding of population health management and community collaboration, healthcare governance, strategic planning and marketing, human resource management, organizational design, project management, financial management, and much more. Health Services Management is a foundational textbook for anyone seeking a challenging and enriching career as a health services manager. Key Features: Provides an easy-to-read text with an engaging style that will appeal to current and future health services managers Listen to more than 30 informational interviews with health services management professionals discussing career topics including roles, responsibilities, and the value of the health service management profession to clinicians and patients Features engaging professional development reflections and career boxes that provide guidance on the technical skills and professional insights needed to succeed in health services management careers Students have access to a glossary featuring more than 700 key terms Qualified instructors have access to expanded Instructor Resources featuring chapter PowerPoints, Test Banks, an Instructor Manual with learning activities, discussion and essay questions for each chapter, and additional resources to supplement students' dynamic learning and interaction with the text
  effective revenue cycle management: The McPherson Principle Michael L. Duke, 2021 Through reading this book, the reader will discover new approaches and concepts related to business rule-driven work tasking and automation, augmented analytics explicitly designed to solve root cause issues within revenue cycle operations, natural language--
  effective 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.
  effective 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.
  effective revenue cycle management: Medical Office Management and Technology Brandy Ziesemer, 2013-03-27 From A to Ziesemer, Medical Office Management and Technology is the text to help student's navigate through their medical office management courses, whether as part of a health information technology, medical administration, or any other allied health program. This text starts at the beginning, with an introduction to new students not familiar with this topic, and works thorugh even the most advanced topics in medical office management. With a special focus on leadership, and a logical progression through the topics, this has the makings of a faculty member's most trusted resource for this course.
  effective 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
  effective revenue cycle management: Leadership for Health Professionals: Theory, Skills, and Applications Gerald R. Ledlow, Michele Bosworth, Thomas Maryon, 2023 Leadership for Health Professionals: Theory, Skills, and Applications applies classical knowledge of leadership theory and time-honored best practices of industry leaders to a health organization context. Themes of leadership principles, applications and constructs such as organizational culture, cultural competency, ethical frameworks and moral practice, scientific methodology, leader competencies, external and internal assessment and evaluation, communication, planning, decision-making, employee enhancement, and knowledge management are woven through the entire text--
  effective revenue cycle management: Health Care Administrator - The Comprehensive Guide ANTILLIA TAURED, Embark on a transformative journey with Health Care Administrator - The Comprehensive Guide, your essential resource for navigating the complex landscape of healthcare management. This book delves deep into the core competencies required for effective leadership, strategic planning, and operational efficiency, offering actionable insights and innovative solutions tailored for today's dynamic healthcare environments. Whether you're an aspiring administrator or a seasoned professional, this guide equips you with the knowledge and tools to excel in your role and drive meaningful change within your organization. Crafted with a focus on practicality and real-world application, this comprehensive guide eschews images and illustrations to ensure a clear, concise, and uninterrupted reading experience. Each chapter is enriched with unique perspectives, personal anecdotes, and hypothetical scenarios that bring theoretical concepts to life, making complex ideas accessible and engaging. By emphasizing original content and in-depth exploration, this book stands out as a must-buy for anyone committed to advancing their career and enhancing the quality of healthcare administration.
  effective revenue cycle management: Leveraging Data in Healthcare Rebecca Mendoza Saltiel Busch, 2017-07-27 The healthcare industry is in a state of accelerated transition. The proliferation of data and its assimilation, access, use, and security are ever-increasing challenges. Finding ways to operationalize business and clinical data management in the face of government and market mandates is enough to keep most chief officers up at night!Leveraging Dat
  effective 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.
  effective revenue cycle management: Excellence Wins Horst Schulze, 2019-03-05 Horst Schulze knows what it takes to win. In Excellence Wins, the cofounder and former president of the Ritz-Carlton Hotel Company lays out a blueprint for becoming the very best in a world of compromise. In his characteristic no-nonsense approach, Schulze shares the visionary and disruptive principles that have led to immense global success over the course of his still-prolific fifty-year career in the hospitality industry. For over twenty years, Schulze fearlessly led the company to unprecedented multibillion dollar growth, setting the business vision and people-focused standards that made the Ritz-Carlton brand world renowned. In Excellence Wins, Schulze shares his approach to everything from providing the best customer service to creating a culture of excellence within your organization. With his tried-and-true methods and inspiring, hard-earned wisdom, Schulze teaches you everything you need to know about: Why leading well is an acquired skill Serving your customers Engaging your employees Creating a culture of customer service Why vision statements make a difference What it really means to practice servant leadership Schulze's principles are designed to be versatile and practical no matter where you are in your career. He'll remind you that you don't need a powerful title or dozens of direct reports to benefit from the advice he shares in Excellence Wins--you have everything you need to apply it to your life and career right now. Let Schulze's incredible story help you unleash the disruptive power of your true potential, beat the competition, own your career trajectory, and experience the game-changing power of what happens when Excellence Wins.
  effective 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.
  effective revenue cycle management: Glaser on Health Care IT John P. Glaser, 2018-09-03 John Glaser has been an astute observer and recognized leader in the health care industry for over thirty years. He has written a regular column for Hospitals & Health Networks in which he comments on a wide range of topics, including improving organizational performance through health information technology (HIT), changes in HIT architecture, challenges in leveraging data, and the evolution of the role of IT leadership. Glaser on Health Care IT: Perspectives from the Decade that Defined Health Care Information Technology is a collection of some of the most widely read articles that have been published in H&HN Daily, H&HN Weekly, and Most Wired Online in the past decade (2005–2015). The columns are dated to show their original publication dates, and the material is organized into four broad themes: HIT Applications and Analytics Challenges Improving Organizational Performance through HIT IT Management Challenges HIT Industry Observations Each section offers readers an intimate look at the myriad issues associated with getting IT right and the organizational performance gains that can be achieved in doing so. Moreover, the book examines the power and potential of the technologies available to health care providers today, as well as the transformative nature of those we have yet to fully embrace. From seasoned CIOs and consultants to software developers and nurses, this book provides invaluable insights and guidance to all those seeking to make the delivery of care safer, more effective, and more efficient through the application of health care IT. Foreword by Russ Branzell, President and CEO, College of Healthcare Information Management Executives (CHIME) Co-published with Health Forum, Inc.
  effective revenue cycle management: Health Care Finance and the Mechanics of Insurance and Reimbursement Michael K. Harrington, 2019-10-01 Health Care Finance and the Mechanics of Insurance and Reimbursement stands apart from other texts on health care finance or health insurance, in that it 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 in detail, correlating it with regular management functions; and covers reimbursement from the initial point of care through claim submission and reconciliation. Thoroughly updated for its second edition, this text reflects changes to the Affordable Care Act, Managed Care Organizations, new coding initiatives, new components of the revenue cycle (from reimbursement to compliance), updates to regulations surrounding health care fraud and abuse, changes to the Recovery Audit Contractors (RAC) program, and more.
  effective revenue cycle management: Healthcare Financial Management , 2008
  effective revenue cycle management: Discharge Planning Handbook for Healthcare Ali Birjandi, Lisa M. Bragg, 2017-11-15 Hidden opportunities to improve profits in the healthcare industry abound in the area of discharge planning. The Discharge Planning Handbook for Healthcare: Top Ten Secrets to Unlocking a New Revenue Pipeline provides innovative new solutions that will show hospital administrators how to turn one of the most antiquated aspects of healthcare into on
  effective revenue cycle management: Long-term Care Administration Handbook Seth B. Goldsmith, 1993 This handbook is the definitive, comprehensive reference for long-term care administration. It provides new ideas, proven approaches, & practical suggestions for every aspect of long-term care facility management. Each chapter contains a collection of specialized, advanced expertise presented by long-term care administrators, consultants, academics, planners, attorneys, architects, & nurses.
  effective revenue cycle management: Essentials of Long-term Care Administration Seth B. Goldsmith, 1994 A comprehensive curriculum of practical methods for long-term care administration. Includes essential forecasting tools compiled and developed by more than 40 leaders in long-term care. Each chapter is followed by case studies, questions, and exercises. Instructor's manual available upon request.
  effective revenue cycle management: 25 Essential Skills for the Successful Behavior Analyst Jon Bailey, Mary Burch, 2023-03-27 This second edition of Bailey and Burch’s best-selling 25 Essential Skills for the Successful Behavior Analyst is an invaluable guide to the professional skills required in the rapidly growing field of applied behavior analysis. The demands on professional behavior analysts, BCBAs and BCBA-Ds, are constantly increasing such that several new skills are required to keep up with new developments. Each chapter has been thoroughly updated and seven new chapters address recognizing the need to understand client advocacy, cultural responsiveness, and the movement toward diversity, equity, and inclusion in the field. The authors present five basic skills and strategy areas which each behavior analyst need to acquire: essential professional skills, basic behavioral repertoire, applying behavioral knowledge, vital work habits, and advanced skills. This book is organized around those five areas, with a total of 25 specific skills presented within those topics.
  effective revenue cycle management: The 340B Program Handbook Andrew L. Wilson, 2018-05-15 Untangle New Requirements and Strengthen Your 340B Drug Program The 340B Program Handbook: Integrating 340B into the Health-System Pharmacy Supply Chain The 340B Drug Program Handbook is the comprehensive guide for pharmacy leaders, hospital administrators, legal counsel, and pharmacy managers. Developed by Andrew L. Wilson, PharmD, FASHP, this practical, clear-cut reference provides the most up-to-date information needed to implement and keep a high-performing program running well, including: · Complying with 340B requirements · Maintaining technical supply chain efficiency · Meeting effectiveness goals · Achieving heath-system financial objectives
  effective revenue cycle management: Issues in Healthcare Management, Economics, and Education: 2013 Edition , 2013-05-01 Issues in Healthcare Management, Economics, and Education: 2013 Edition is a ScholarlyEditions™ book that delivers timely, authoritative, and comprehensive information about Health Care Management. The editors have built Issues in Healthcare Management, Economics, and Education: 2013 Edition on the vast information databases of ScholarlyNews.™ You can expect the information about Health Care Management in this book to be deeper than what you can access anywhere else, as well as consistently reliable, authoritative, informed, and relevant. The content of Issues in Healthcare Management, Economics, and Education: 2013 Edition has been produced by the world’s leading scientists, engineers, analysts, research institutions, and companies. All of the content is from peer-reviewed sources, and all of it is written, assembled, and edited by the editors at ScholarlyEditions™ and available exclusively from us. You now have a source you can cite with authority, confidence, and credibility. More information is available at http://www.ScholarlyEditions.com/.
  effective revenue cycle management: Financial Management of Health Care Organizations William N. Zelman, Michael J. McCue, Noah D. Glick, Marci S. Thomas, 2020-08-14 This thoroughly revised and updated Fifth Edition of Financial Management of Health Care Organizations offers an introduction to the tools and techniques of health care financial management. The book covers a wide range of topics, including information on 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. The revised edition covers new accounting changes for nonprofit hospitals with respect to net asset accounts, and includes an array of new financial statement problem sets for nonprofit hospitals. These changes also required major changes to the recording of financial transactions and implementing the latest financial ratio benchmarks. With the newest payment developments in the health care landscape, this new edition updates changes to Medicare and commercial payment systems. The passage of the new tax law also impacted hospital capital markets and for-profit hospital tax rates. This latest edition explains the impact of this tax law change on tax-exempt hospital bonds purchased by banks, as well as presenting problem sets featuring the new taxes law. Finally, changes in lease financing reporting are also addressed in this edition.
  effective revenue cycle management: It's All Analytics, Part III Scott Burk, Gary Miner, 2023-09-15 Professionals are challenged each day by a changing landscape of technology and terminology. In recent history, especially the last 25 years, there has been an explosion of terms and methods born that automate and improve decision-making and operations. One term, called analytics, is an overarching description of a compilation of methodologies. But artificial intelligence (AI), statistics, decision science, and optimization, which have been around for decades, have resurged. Also, things like business intelligence, online analytical processing (OLAP) and many, many more have been born or reborn. How is someone to make sense of all this methodology, terminology? Extending on the foundations introduced in the first book, this book illustrates how professionals in healthcare, business, and government are applying these disciplines, methods, and technologies. The goal of this book is to get leaders and practitioners to start thinking about how they may deploy techniques outside their function or industry into their domain. Application of modern technology into new areas is one of the fastest, most effective ways to improve results. By providing a rich set of examples, this book fosters creativity in the application and use of AI and analytics in innovative ways.
  effective revenue cycle management: Let The Cash Flow: A practical guide to getting paid on time by your customers Simon J. Littlewood, Mark Laudi, 2021-04-15 Any business that allows their customers credit terms will invariably run into late or non-payments. This affects cash flow and business viability. However, as the authors show, customers that are solvent will pay some suppliers every month, even if they don't pay everyone. So how do you ensure you are first in line to get paid? This book examines the strategies that work – and those that don't. The authors introduce a simple but highly effective model, the Virtuous Revenue Cycle, that shows readers how to cultivate business relationships that keep the cash flowing. The strategies are highly practical, down to advice on just how to phrase those tricky emails reminding customers to pay up!
  effective revenue cycle management: Health Care Administration Lawrence Wolper, 2011 Health Care Administration: Managing Organized Delivery Systems, Fifth Edition provides graduate and pre-professional students with a comprehensive, detailed overview of the numerous facets of the modern healthcare system, focusing on functions and operations at both the corporate and hospital level. The Fifth Edition of this authoritative text comprises several new subjects, including new chapters on patient safety and ambulatory care center design and planning. Other updated topics include healthcare information systems, management of nursing systems, labor and employment law, and financial management, as well discussions on current healthcare policy in the United States. Health Care Administration: Managing Organized Delivery Systems, Fifth Edition continues to be one of the most effective teaching texts in the field, addressing operational, technical and organizational matters along with the day-to-day responsibilities of hospital administrators. Broad in scope, this essential text has now evolved to offer the most up-to-date, comprehensive treatment of the organizational functions of today's complex and ever-changing healthcare delivery system.
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The critical role of effective revenue cycle management (RCM) is unprecedented in healthcare. As multiple regulatory initiatives converge with existing demand for faster billing cycles and cost …

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In the complex world of healthcare, effective revenue cycle management (RCM) plays a pivotal role in ensuring financial stability and operational efficiency for medical practices. RCM …

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REVENUE CYCLE MANAGEMENT: FINANCIAL STABILITY FOR THE FUTURE OF HEALTHCARE Introduction The critical role of effective revenue cycle management (RCM) is …

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care is convincing revenue cycle leaders to consider new strategic alternatives to the status quo. It will also provide insight into contracting options, a strategy road map, advice for evaluating …

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Effective date: Original effective date Scope - The University …
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A Dark Daily WhitePaper
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From revenue cycle management to revenue excellence
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health system executives are using outside partners to manage their revenue cycle. Many realize that revenue cycle management is not an organizational core competency. In fact, in some …

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revenue cycle management (RCM), Change Healthcare commissioned Engine to conduct a signature research study involving revenue cycle, IT, and executive and financial leaders. The …

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Lake Land College
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