White Papers

Healthcare providers are struggling with the constantly changing reimbursement, regulatory requirements of the healthcare complex claims environment and the ever-increasing cost of healthcare. A tremendous starting point for the revenue cycle is to incorporate a healthcare analytics program into their base functionality.

Healthcare providers are struggling with the constantly changing reimbursement, regulatory requirements of the healthcare complex claims environment and the ever-increasing cost of healthcare. A tremendous starting point for the revenue cycle is to incorporate a healthcare analytics program into their base functionality.

The size of the resulting missed opportunity should not be underestimated. Healthcare reform has expanded access to care; however, it has also added complexity, as has market trends (i.e., prior-authorization requirements) and other new government requirements. These forces, along with the consumer-driven nature of healthcare, providers have and will continue to compensate for the historic […]

Fifteen cents of every US healthcare dollar is associated with revenue cycle inefficiencies. Of the $3.9 trillion the country spends annually on healthcare, almost $500 billion is a result of claims processing, payments, billing, revenue cycle management (RCM), and bad debt issues; in part, because half of all payer-provider transactions involve inefficient methods. Enhanced solutions […]

The percentage of hospitals outsourcing complex claims has doubled over the past several years.  The number of complex claims outsourced to specialized, third-party companies has increased from 20.4% to 39.8% and continues to grow. [1] Nationwide, reduced operating margins require healthcare management to capture 100% of net expected reimbursement, according to the recent survey responses […]

Healthcare providers and insurance companies are struggling with the increasing cost of revenue management and the ever-changing reimbursement/regulatory/administrative requirements of the healthcare environment.  The Pre-Service Clearance Program provides a comprehensive suite of patient centric programs to provide solutions to resolve these issues through an enhanced scope of revenue management services, teamed with a world-class experience […]