Medical Billing Denials Are Avoidable: How to Help Prevent the Top 5

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To help manage the complexity surrounding your denials management program, we’ve written this article to help you better understand how denials affect your organizations’ revenue, cash flow and operational efficiency.

In this article, we’ve laid the framework to help you take a proactive role in preventing these denials, including:

  • Understanding the role denials play in your overall bottom line
  • Helping you establish medical billing benchmarks, reducing backlogs, identifying root causes
  • Outlining eight key elements that should be part of your denials management program
  • Sharing strategies for the most efficient and sustainable way to augment your revenue cycle team
  • Offering practical advice from a revenue cycle leader with experience at large health systems across the country

If you are a CFO or someone responsible for managing any piece of the revenue cycle at your hospital, you’ll appreciate this overview of the top reasons for medical billing denials, how to prevent them in the first place, and reviews key strategies for efficient and cost-effective denials management that you and your teams can put into place today.

Not only a great reference tool for your revenue cycle team, but this is also great reading to share with your patient access team members as many denials stem front front-end processes. Take a proactive role and help reduce your denials today.

Rise of the Third Payer: Disrupting the Patient Payment Culture

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With patient deductibles and out-of-pocket costs increasing rapidly in the past five years, hospitals have been put in a difficult position of providing a consumer-friendly billing experience while at the same time reducing bad-debt and cost-to-collect. For patients, hospital bills are often inconvenient, not understandable, and not affordable.

This report will cover the difficult topic of changing the status quo and laying the groundwork for an organization-wide, sustainable approach to changing the culture of patient engagement at your facility.

  • Establishing the Vision – decide how your organization can best accommodate alternative payment models and patient consumerization
  • Creating a Culture of Engagement - Your frontline staff will need updated training and tools in order to meet these challenges.
  • Employing Technology – from eligibility verification to payment plans, leaving your front-line staff with technology gaps creates compounded problems for both collections and denials.
  • Empowering Patients – by providing resources and options, not restrictions.

Unlocking Big Data for Healthcare

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Privacy Analytics

PHI is the most sensitive of all data – and unlocking it for Big Data Analytics is no easy feat. The risk of reidentification grows along with the size of health data being created. Fears around patient privacy hinder progress.

This white paper discusses the inherent risks in large and linked datasets and offers guidance on the steps companies can take to protect patients and themselves.

Healthcare Fiduciary's Handbook

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Russell Investments

To help manage the complexity surrounding your investment program, we’ve written the Healthcare Fiduciary’s Handbook. In this step-by-step guide, we’ve laid the framework to help you manage the complexity surrounding your investment program. The handbook includes:

  • An intuitive framework to effectively oversee your investment program.
  • Practical advice from Russell Investment experts on aligning your asset pools with your organizational goals.
  • How to target your investment objectives by aligning your investment beliefs.

If you are a Board member, serve on the Investment Committee, or are the trustee or CFO of a non-profit hospital or health system, this reference book was written for you. The Healthcare Fiduciary’s Handbook provides practical advice, planning tools, and information on best practices to help you understand and successfully fulfill your fiduciary responsibilities.

Not only a great reference tool, the Healthcare Fiduciary’s Handbook is also a great primer for new Board and Investment Committee members.

Finding a Faster Path to Value-Based Care

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Quest Quanum

New Study of Physicians and Health Plan Executives

The U.S. healthcare system is progressing along a continuum from volume- to value-based care models where physicians and health systems aren’t simply compensated for doing more, but instead for delivering higher-quality care at a better value. The transition hasn’t been easy, however, and much has been written about new burdens placed upon health plans, hospitals, ACOs and physicians.

This study reveals that the complexity of quality measures and physicians’ lack of access to patient data at the point of care are barriers to the healthcare industry’s adoption of value-based care.

State of Software Security

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Is the healthcare industry’s underlying DNA holding it back in terms of security?

In the security arena, healthcare is struggling. As compared to its industry peers, healthcare now has the lowest vulnerability fix rate, the second-lowest OWASP pass rate, and the highest prevalence of cryptographic and credentials management issues.

These statistics were uncovered in our most recent Veracode annual State of Software Security report, which provides an overall status on security issues and threats across industries. Healthcare is one of our focus areas, and here’s what we found:

  • Healthcare ranks lowest on fix rates; only 34% of vulnerabilities were fixed the first time
  • 67% of applications failed first-time scans based on OWASP policy compliance pass rates
  • The top 3 vulnerability categories for the healthcare industry were cryptographic issues, information leakage, and code quality

Given the concern for sensitive patient data under HIPAA regulations, these types of data-endangering vulnerabilities are especially troubling. So, how do you prioritize security for your patient information? And, how does your organization compare with its industry peers?

Download the State of Software Security report today. You’ll find helpful, in-depth information specific to the healthcare industry on a number of key security issues.