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Revenue Cycle Management

Out-of-Network Providers Are Winning in IDR: What Healthcare Leaders Need to Know

June 12, 2025
out-of-network reimbursement

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…

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How the No Surprises Act and IDR Process Help Providers Recover Out-of-Network Revenue

June 3, 2025
No Surprises Act

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…

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The High Cost of Denials: How Prior Authorization Challenges Are Draining Your Bottom Line

May 28, 2025
prior authorization denied

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…

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Precertification vs. Preauthorization: What Healthcare Executives Need to Know

May 2, 2025
precertification insurance

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…

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How to Integrate CDI into Your Billing Process for Higher Accuracy

April 23, 2025
medical billing 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…

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The Growing Stress on Nurses and Clinicians – Prior Authorizations

April 17, 2025
Stress Awareness Month

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…

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The Growing Stress in Healthcare – Prior Authorizations

April 8, 2025
Stress Awareness Month

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…

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The Current State of Patient Access in 2025: Challenges and Innovations

April 1, 2025
patient access

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…

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Maximizing Accuracy: The Essential Role of CDI in Healthcare

March 6, 2025
Clinical Documentation Improvement

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…

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The Human Touch in Prior Authorizations: Why Technology Alone Isn’t Enough

February 10, 2025
prior authorization specialist

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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Services
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Recent Posts

  • Case Study: Cass Medical Center Slashes Prior Authorization Denials and Recovers Revenue
  • Out-of-Network Providers Are Winning in IDR: What Healthcare Leaders Need to Know
  • How the No Surprises Act and IDR Process Help Providers Recover Out-of-Network Revenue
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