Top 30 resources to review and implement for starting off the new year right.
Claims and Denials
The financial health of your organization hinges on your ability to capture reimbursement quickly and completely, without the disruption of claim denials.
Can You Afford to Lose Money on Preventable Claim Denials?
The goal for every claim going out the door is to avoid a denial and get paid as quickly as possible. Combining revenue cycle performance data with artificial intelligence, healthcare leaders can predict areas within each claim’s lifecycle that are likely to result in a denial.
Prevent Denials with Early Insight into Patient and Payer Information
Labs often do not get the same interaction with patients as a traditional provider, in which they are collecting patient and payer information. A Patient Access Management (PAM) solution will collect the necessary patient demographic and payer information to be reimbursed for patient services and avoid the costly domino effect of denial management.
Claim Denials Steadily Increasing—What You Need to Know
The hospital claim denial rate has been steadily increasing since 2016, but the COVID-19 pandemic has accelerated the upward trajectory, pushing the denial rate up from 20% in the second quarter. Identification of root causes, prioritization and leveraging technology can avert hospital revenue loss.
Up to 5% of Revenue is Lost to Preventable Leakage
One important piece of the revenue cycle that is often overlooked is contract management. Remarkably, 7 to 11% of claims are underpaid. Integration and intelligent analytics enables its clients to see, manage and act on leakage issues rapidly and at scale with minimal additional resources.
Are Clearinghouse Constraints Holding You Back From Revenue Cycle Optimization?
The functions performed by the claims clearinghouse continue to be of crucial importance in the healthcare ecosystem to streamline reimbursement and fuel the revenue cycle.
Realign Claim Follow-Up Value For Today’s Revenue Cycle
Effective claim follow-up enables a healthcare facility to proactively identify and begin working claim denials or requests for additional documentation. How do you overcome these concerns? Access real-time claim status during payer adjudication with just a click.
Collect More Revenue with "Clean" Claims
When it comes to healthcare claims, cleanliness is next to, at the very least, fiscal fitness. Producing claims that are “clean” and therefore immediately reimbursable is an important factor in reducing cost-to-collect. Find out how to streamline your claims management process.
Is Your Cash Flow Engine Running at Peak Efficiency for Reimbursement?
The tool you use for scrubbing and submitting your healthcare claims is only as good as the library of claim processing rules and edits under the hood that will identify errors before you submit. Discover the five essential elements of a claim edits library that will positively impact your cash flow.
How Your Payer Dictionary Can Impact Your Clean Claim Rate
For fastest and most reliable cash flow possible, keep your payer dictionary up to date and your claims matched accordingly with regular maintenance.
Automation and Efficiency
Automation of inefficiencies throughout the revenue cycle represents the greatest opportunity for reduced costs and increased net collections.
Achieve Higher Claims Approval Rates with Automation
Claims accepted on the first pass reduce a provider’s processing costs, shorten time-to-payment, and lead to more reliable forecasts.
Is Lack of RCM Automation Putting Your Revenue At Risk?
A goal for every lab, hospital and healthcare system is to build a resilient revenue cycle that can bring in a steady revenue stream that is not susceptible to disruptions and provide relief to labor challenges.
5 Things Technology Can Do, and 7 Things it Can’t.
Shrinking margins dictate smaller teams, while the complexity of achieving reimbursement only increases. In this environment, relying on advanced, highly-automated technology is essential, but so is having a good partner to provide personalized support and expertise.
The Right Automation is More Important Than Ever
There are more technology-driven opportunities to ‘fix’ your RCM than ever before. With all the solutions out there, why aren’t healthcare organizations getting better results? Learn more about the solutions to these hurdles.
Avoid the Top 3 RCM Pitfalls with Automation
If healthcare revenue cycle management technology has been evolving for over two decades, and the point of most technology is to help processes run more efficiently, what is causing administration costs to be sky-high with such an enormous opportunity for savings?
RCM Resiliency: Be Ready for Volume-to-Value Operational Pressures
Resiliency in your revenue cycle operations is the best defense against the high administrative costs and risks to reimbursement caused by volume-to-value payment models. Check out the best practices for reimbursement.
Automation – The Key to Hospital Transformation
In this webinar, Kathy Whitmire, CEO of Transformation Health Partners, discusses how critical automation is to the revenue cycle for healthcare providers to survive after COVID-19.
Patient Billing and Payments
Technology and digital communications are providing advanced and convenient ways to engage patients in their financial responsibilities through text, email and online portals.
The Lab Revenue Cycle is Increasingly Patient-Facing and Digital
Various market forces are driving the revenue cycle for clinical labs increasingly online. To manage the shift, labs will need to rely more on automation and more interactive, self-serve modes of collection in the revenue cycle.
Give Patients What They Want for a Healthier Revenue Cycle
Patients often depend on their healthcare provider to educate them on the status of their claims, and increasingly some manner of automated, patient-facing billing and communication processes are becoming the norm. Learn the competitive advantage in meeting patient expectations.
Improve Your Cash Flow with Patient Payment Portal
A self-service portal provides digital payment options, improving your revenue and providing patients with greater awareness, understanding, and control over their financial responsibility.
Create RCM Resiliency with Patient Payment Best Practices
Given its high costs to collect and percentage of overall revenue, healthcare organizations need to prioritize patient balances and encourage on-time payments to build a resilient revenue cycle that keeps cash flowing.
Patient Collections: Are Contactless Payments Critical Moving Forward?
Healthcare consumerism has been on the rise for the last several years, but the pandemic propelled it to the forefront even more as more patients report the desire to use telehealth and contactless payment options post-COVID-19. The overall patient experience is going to continue to be more and more important as consumerism soars. It will be a leading driver in the long-term success of healthcare providers.
The Root Causes of Surprise Billing and How Providers Can Help
Surprise billing is very much a reality for many patients for a myriad of reasons. A patient access solution can provide your patients with communication and price transparency, leading to higher satisfaction rates.
Patient Bad Debt Impacting Your Bottom Line?
In this webinar, discover the benefits gaining insights into consumer financial behaviors to increase registration process accuracy, create more transparent and positive patient experiences, empower staff members to make consistent intelligent decisions, and offer providers a way to maximize staff efficiency.
Service, Support, and Partnership
Partnering with the right revenue cycle vendor can have a significant impact on your bottom line by helping find ways to make your organization more efficient and successful.
Does Your Claims Management Vendor Check All The Boxes?
The financial health of your organization hinges on your ability to capture reimbursement quickly and completely. Ask the right questions when evaluating a claims management vendor to avoid delays due to inefficiency and/or inaccuracy.
Not All Service Is The Same—Does Your Revenue Cycle Vendor Deliver?
This checklist outlines the questions you should ask potential vendors on their service model, so you can match your expectations to their capabilities, and gain a clear understanding of what their solution can (or cannot) deliver.
How to do an Apples to Apples Vendor Comparison
Once you’ve made the decision to make a move, perhaps breaking free from clearinghouse constraints that may have held you back, how do you make an equitable, apples-to-apples comparison to determine which vendor will be the best fit as partner for your organization?
Cybersecurity
As one of the top five most targeted industry sectors, healthcare is under attack by online hackers. Being cyber smart and partnering with trusted providers is imperative.
Quadax Achieves New “Cybersecurity Transparency” Status From KLAS, Censinet
As data breaches against healthcare organizations are on the rise, by advancing the Quadax information security program, and utilizing strategies such as defense-in-depth, the company is diligently building safeguards to protect patient data, prevent potential breaches and providing ongoing detection of new cyber threats.
Don’t Misplace Your Trust — Choose a SOC 2 Certified Service Provider
A breach, crash, or targeted attack can be devastating to an organization; partner with a SOC 2 compliant vendor, where patient data is subject to stringent HIPAA compliance regulations for privacy and security.
Even Computers Get Viruses—Cybersecurity and Healthcare
If the pandemic has taught us anything, it's that malicious cybercriminals show no signs of slowing their efforts to access sensitive health information, emphasizing the need for healthcare organizations to have a data protection strategy capable of safeguarding against new and emerging cyber threats.
Thwart Cyber Threats – Employee Security Awareness & Training
Your organization is only as secure as your employees (and vendors) are aware. Enterprise-wide cybersecurity awareness training can strengthen your frontline defense.
For nearly 50 years, Quadax has been supporting the financial health of a diverse set of clients, from large multi-state healthcare campuses to cutting edge genomic and molecular diagnostic labs. Our unified Revenue Cycle Management solutions will manage the entire rev cycle process so you can deliver the best possible patient care without compromising reimbursement goals. With Quadax as your reliable partner and dedicated service provider, you can achieve operational efficiency, optimize financial performance and enhance the patient experience. We’d love to talk to you, to understand your financial objectives and share how we can help you meet or exceed them.
Let’s take on the revenue cycle together!
