A new analysis by Change Healthcare of $3 trillion in medical claims submitted to payers last year revealed 9% of charges, representing $262 billion, were initially denied. For the typical health system, as much as 3.3% of net patient revenue, an average of $4.9 million per hospital, was put at risk due to denials. While 63% of these claims were recoverable on average, reworking each denial costs providers roughly $118 each, or as much as $8.6 billion in appeals-related administrative
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Revenue Integrity: Realizing the Promise of Hospital/Physician Integration
Editor's Note: Dan Ward is the VP of Strategy at ZirMed, a company empowering healthcare organizations to optimize revenue and population health with an end-to-end platform of cloud-based financial and clinical performance management solutions. HIT consultants see firsthand the growing pains of health systems as they increasingly purchase or partner with physician practices. While the aim is to increase efficiency, avoid duplication, lower costs and improve care, the reality is often very
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How Predictive Analytics Brings a Moneyball Approach to Improve Healthcare Financial Performance
Editor's Note: Paul Bradley, PhD, is the Chief Data Scientist at ZirMed, a company empowering healthcare organizations to optimize revenue and population health with an end-to-end platform of cloud-based financial and clinical performance management solutions. Predictive analytics – using data, statistical algorithms and machine learning techniques to identify the likelihood of future outcomes based on historical data – has become a staple of many industries.Brick-and-mortar retailers use it to
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St. Joseph’s Healthcare System to Implement Cerner’s EHR, Financial and Population Health System
St. Joseph’s Healthcare System has selected Cerner to implement its integrated EHR and revenue cycle management system across its acute, long-term care and ambulatory facilities. The Cerner Millennium EHR and HealtheIntentS, Cerner’s near real-time population health management system that aggregates data from multiple sources, will support St. Joseph’s nearly 1,000 beds. HealtheIntent will establish a longitudinal record, which will provide St. Joseph’s clinicians with a comprehensive, unified
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Intermedix Acquires WPC Healthcare to Optimize Revenue Cycle Through Predictive Analytics
Intermedix Corporation, a provider of data analytics and cloud-based technology has acquired healthcare data analytics provider WPC Healthcare. The Nashville, TN-based data analytics company uses machine learning to make predictions about health care conditions providing early notification to health care providers and, ultimately, saving lives while decreasing costs. Financial details of the acquisition were not disclosed. In 2015, Intermedix announced the creation of its analytics business
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Career Step Acquires Panacea Healthcare Solution’s Revenue Cycle Management Divisions
Career Step, LLC, a portfolio company of Revelstoke Capital Partners, a Denver-based private equity firm has acquired the Revenue Capture and Coding and Documentation Divisions of Panacea Healthcare Solutions. After completion of the acquisition, Career Step and Panacea will now provide end-to-end education, consulting and data analytics solution to the revenue cycle and healthcare financial marketplaces. Financial details of the acquisition were not disclosed.For Career Step, the acquisition
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athenahealth, ADP Integrate to Deliver Cloud-Based Payroll to Hospitals
athenahealth, a provider of network-enabled services and mobile apps for healthcare providers has integrated with ADP to to deliver payroll and time and attendance services to the small hospital market. The integration of ADP Workforce Now® payroll and time and attendance solutions with athenaOne for Hospitals & Health Systems® aims to save hospital and health system administrators’ time, effort and money by automating payroll processes and increasing operational efficiencies.Integration
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nThrive Acquires Clinically Integrated Revenue Cycle Provider Adreima
nThrive, an Alpharetta, GA-based provider of revenue cycle solutions has acquired Adreima, a Downers Grove, Ill.-based provider of patient-centered, clinically-integrated revenue cycle services that help patients find coverage and meet their financial obligations, while partnering with health care providers to optimize revenue cycle functions. Financial terms of the acquisition were not disclosed. For nThrive, the acquisition strengthens it's patient-to-payment roadmap that are essential to
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UCSF Taps referralMD to Reduce Patient Wait Times
University of California at San Francisco, Department of Oral and Maxillofacial Surgery (UCSF-OMS) has partnered with ReferralMD, an enterprise patient access platform to reduce patient wait times. As part of the partnership, UCSF has implemented ReferralMD's patient access platform to provide regular feedback to referring providers, prevent lost referrals, and centralize their referral management process. Prior to going live with ReferralMD, UCSF-OMS received faxed referrals from hundreds of
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Revenue Cycle Management Vendor Recondo Lands $16M to Fuel Solutions Growth
Recondo Technology, a Greenwood Village, CO-based provider of cloud-based revenue cycle management solutions has raised $16 million in debt and capital funding led by Lehmi Ventures with Bridge Capital serving as the debt partner. The company plans to utilize the funding to support product development investments, particularly in areas of API-enabled revenue cycle content, expanded claims statusing, and authorization automation—all solutions designed to measurably improve financial
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