As the healthcare industry continues to shift towards value-based care models, revenue cycle management (RCM) is becoming increasingly complex. In order to optimize RCM for value-based care, healthcare organizations must embrace new payment models, focus on quality and outcomes, and leverage technology solutions that can streamline their RCM processes. In this blog post, we’ll explore
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As the healthcare industry evolves, so does the need for accurate and efficient Quality Assurance (QA) in Revenue Cycle Management (RCM). QA is a critical process that ensures the accuracy and completeness of your claims data and is essential for successful claims and refunds. Unfortunately, the current manual processes used for quality assurance in RCM
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The field of medical coding is one of the most critical and complex areas in the healthcare industry. Accurate coding is essential for several reasons, including ensuring proper reimbursement for healthcare providers, facilitating efficient revenue cycle management, and maintaining compliance with federal and state regulations. However, despite its importance, medical coding can be a challenging
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Fast Healthcare Interoperability Resources (FHIR) is a revolutionary new standard for exchanging healthcare information electronically. Developed by Health Level Seven International (HL7), FHIR is designed to make it easier for healthcare systems to share data and improve the quality of care for patients. This standard is based on the latest web standards and technologies, making
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The practice of managing the financial aspects of patient care is known as revenue cycle management (RCM), and it is a crucial part of the healthcare sector. RCM aims to make sure that healthcare providers are promptly and effectively compensated for the services they render. Patient registration, appointment scheduling, claims submission, payment processing, and patient
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Technology can play a significant role in improving the patient’s financial experience in the healthcare industry. They can provide patients with easy access to their healthcare facilities, medical billing, insurance for making payments, and a simple process of healthcare organizations. Additionally, they can offer patients personalized cost estimates and financial assistance options, helping to reduce
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Healthcare Fraud, According to NHCAA financial loss due to healthcare fraud is billions of dollars. Approximately 3% of total health care expenditures, while some government and law enforcement agencies place the loss as high as 10% of our annual health outlay. Fraud in Revenue Cycle Management (RCM) is a significant concern for healthcare providers and
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The Payment Card Industry-Data Security Standards (PCI DSS) include a set of security standard guidelines to ensure all companies that accept, store, process, or transmit credit card data maintain a safe payment environment. Compliance with these standards is mandatory for all merchants and service providers that accept credit card payments. This blog will provide a
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In the healthcare sector, many manual processes and decisions depend on the precision of healthcare data. For instance, patient onboarding in the organization, follow-up appointments, reports & prescription storage, medical billing, and claims management are a few data-intensive processes in a healthcare system. Considering these factors, Robotic Process Automation (RPA) can benefit the industry by
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According to the International Diabetes Federation , in 2021, 53.7 million adults in the age group of (20-79) years had diabetes. Around 1.2 million children and adolescents (0-19) years have type 1 diabetes. Diabetes is a chronic condition that can lead to serious health problems like vision loss, heart disease, and kidney disease. Hence, diabetic
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