Revenue Recovery Strategies for Hospitals and Health Systems

Sponsored by
Inovalon

Financial challenges remain a consistent and growing concern for hospitals. These challenges stem from the global pandemic, like a shifting payer mix and a drop in elective procedures. Others have been here all along – complex medical billing rules, changing regulations, and bad debt, just to name a few – but have suddenly come into sharper focus. In this white paper, learn techniques for overcoming old and new revenue challenges by adopting a different perspective on the traditional claim lifecycle.

Conventional strategies for addressing reimbursement shortfalls are reactive: tracking down missing patient information, correcting claims errors post rejection, chasing delinquent self-pay accounts, and so on. A proactive approach that addresses issues before, during, and after a claim, on the other hand, is more effective in capturing revenue; it saves time and requires less labor.

Hospitals large and small are leveraging these strategies to stop revenue leaks, decrease days in A/R, improve cost-to-collect ratios and improve patient satisfaction. Download the white paper now to discover how more robust coverage discovery and eligibility verification solutions can help you preserve financial stability and position your organization for a more secure future.

Case Study: Transforming Financial Clearance and Prior Authorization Processes

Sponsored by
Waystar

With 15 hospitals in three states and almost four million patient visits per year, UCHealth needed to transform its processes for financial clearance and prior authorization in preparation for its next phase of growth.

Manual, high touch payer interactions, lack of payer authorization rules, and decentralized processes continued to negatively affect staff capacity, wasting up to 70% of staff time. This led to a near-constant need to hire more employees, higher than- necessary delays in securing authorization and increased denials and write-offs.

In this case study, learn how UCHealth was able to:

  • Save up to $720,000 in FTE salaries
  • Improve speed of prior authorizations by 340%
  • Significantly decrease ‘no authorization’ write-offs
  • And more!

Is Technology the Answer to the Worsening Denials Problem?

Sponsored by
Experian Health

Industry survey shows nearly two-thirds of providers audited claims technologies as denials increased during the pandemic.

While denials are not a new headache, they are a problem that worsened throughout the pandemic for most hospitals and health systems. A recent Experian Health–sponsored survey by HealthLeaders reveals denials increased at 80% of healthcare organizations since 2019, with 43% experiencing a 10% to more than 20% increase. Thirty percent of organizations say 10% to more than 15% of claims lead to a denial.

In this exclusive report, gain key insights into how leaders from across the healthcare ecosystem view the worsening denials problem along with various perspectives on the impacts of expanding technology. 

Operational Assessment: The First Step to Long-term Sustainability

Sponsored by
Community Hospital Corporation

An operational assessment helps hospitals leverage their strengths and identify innovations to enhance performance and boost the bottom line while setting hospitals toward a better future.

Download now to gain insights about how an in-depth assessment of your hospital operations can help best serve your community in these changing times.

What's Next For The CMIO?

Sponsored by
IMO Health

Despite its relatively brief history, the role of the Chief Medical Information Officer (CMIO) has changed a lot in a few short decades. Originally, CMIOs oversaw the implementation and adoption of the electronic health record (EHR), but today, they are responsible for more complex, constantly changing initiatives requiring them to wear the hats of clinicians, IT experts, and department liaisons – to name just a few. So, what will this position look like in the future?

In this insight brief, we asked 10 CMIOs from across the country to answer one question: How will the role of the CMIO change in the years ahead, and what challenges or opportunities will this present?

From leveraging artificial intelligence to the importance of resilience to the standardization of workflows, their responses were wide-ranging, insightful, and certain to spark meaningful discussions within health systems and beyond.

Meet Member Needs with Scalable Mental Healthcare That Works

Sponsored by
Amwell

For the increasing number of individuals experiencing mental health needs, it is imperative that health plans be able to meet them with low barrier treatment approaches where they are, whether they are diagnosed at a routine primary care appointment, with a specialist monitoring a chronic condition, or as an acute case in the emergency department – and then to follow those individuals as they progress along their journey within a health network’s care continuum.

 

As health plans revamp their offerings to incorporate mental healthcare in new ways, it will be necessary to:

 

1. Revisit the traditional approach of covering only in-person therapy – which cannot be scaled to meet current or projected demand.

2. Critically evaluate any treatment offered within the health plan formulary to ensure members derive outcome value and the plan derives a positive return on investment.

3. Deploy mental healthcare that informs, and is informed, by other care team members In doing so, health plans will be better able to meet each member where they are on the spectrum of mental health needs.

 

Doing so with platforms that integrate seamlessly onto the clinical care continuum also improves access to mental health resources for members by creating new opportunities for clinicians to identify – and then act on – each members’ holistic behavioral health needs. It’s an approach that’s proven to improve member outcomes and reduce overall health costs.

 

In this White Paper, you will read that more people are seeking mental health support and seeking it in expensive places. This White Paper presents less expensive options that are proven to work. 

 

 

 

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