Revenue Cycle Management
Out-of-Network Providers Are Winning in IDR: What Healthcare Leaders Need to Know
Since the No Surprises Act (NSA) went into effect in 2022, out-of-network (OON) providers have increasingly relied on the federal Independent Dispute Resolution (IDR) process to recover fair payment for…
Read MoreHow the No Surprises Act and IDR Process Help Providers Recover Out-of-Network Revenue
In today’s healthcare environment, providers face constant pressure to secure fair reimbursement, especially for out-of-network services. The No Surprises Act (NSA), implemented in January 2022, was designed to protect patients…
Read MoreThe High Cost of Denials: How Prior Authorization Challenges Are Draining Your Bottom Line
For healthcare CFOs tasked with preserving margins amid tightening reimbursements and rising labor costs, claim denials represent a persistent and costly challenge. One of the most significant and avoidable drivers…
Read MorePrecertification vs. Preauthorization: What Healthcare Executives Need to Know
In today’s complex healthcare landscape, understanding the nuances between precertification and reauthorization (prior authorization) is crucial for healthcare executives aiming to optimize administrative processes, reduce claim denials, and enhance patient…
Read MoreHow to Integrate CDI into Your Billing Process for Higher Accuracy
As value-based care and payer scrutiny increase, healthcare executives face growing pressure to tighten operations and reduce claim denials. One of the most strategic ways to increase billing accuracy and…
Read MoreThe Growing Stress on Nurses and Clinicians – Prior Authorizations
April is Stress Awareness Month, a critical time to shed light on the mounting pressures facing healthcare professionals, particularly nurses, providers, and clinical support staff. While healthcare workers are hailed…
Read MoreThe Growing Stress in Healthcare – Prior Authorizations
April is Stress Awareness Month, a critical time to shed light on the mounting pressures facing healthcare professionals, particularly nurses, providers, and clinical support staff. While healthcare workers are hailed…
Read MoreThe Current State of Patient Access in 2025: Challenges and Innovations
Patient access will remain a top priority for healthcare providers, payers, and policymakers in 2025. As the industry continues to evolve, improving access to care has become essential for reducing…
Read MoreMaximizing Accuracy: The Essential Role of CDI in Healthcare
In the constantly changing landscape of healthcare, accurate and comprehensive clinical documentation is critical for both patient care and financial stability. Clinical Documentation Improvement (CDI) helps healthcare facilities enhance documentation…
Read MoreThe Human Touch in Prior Authorizations: Why Technology Alone Isn’t Enough
Technology is transforming many aspects of patient care and administrative workflows in the evolving field of healthcare. Among these advancements, automation tools and artificial intelligence (AI) are streamlining processes like…
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