A 90-day delay in provider enrollment and credentialing for a single physician can put hundreds of thousands, and in some specialties, over $1 million, in revenue at risk. When enrollment timelines drag, practices can’t bill payers, claims are denied, and cash flow slows. Yet many organizations still treat provider enrollment and credentialing as an administrative […]
Accurate financial reporting is the backbone of strong healthcare finance. For CFOs and financial analysts, reliable numbers aren’t just “nice to have.” They’re essential for forecasting, evaluating performance, navigating reimbursement challenges, and guiding strategic decisions. But in many organizations, financial reporting is inconsistent, delayed, or dependent on manual work that increases the risk of error.
Stronger Healthcare Financial Reporting Starts Here Read More »
When it comes to healthcare finance, one of the most confusing and misunderstood topics is revenue recognition. For most industries, revenue recognition is relatively straightforward: you sell a product, you record the sale, you collect payment. But in healthcare? It’s never that simple. Between complex payor contracts, contractual adjustments, patient responsibility, and the nuances of
If you’re not performing Zero Balance Reviews (ZBRs), you could be leaving money on the table. Worse yet, you might be missing patterns of underpayment, denials, or contractual misinterpretations that cost your organization thousands or more. In this blog, we’ll walk you through what zero balance reviews are, why they matter, and how they can
Why Zero Balance Reviews Are a Must for Every Organization Read More »
Most providers don’t have the time—or desire—to get into the weeds of payor contracting. Contracts are signed, stored away, and rarely looked at again. But those agreements still control how you get paid today. If your contracts haven’t been reviewed in a few years, chances are you’re due for a serious update. Outdated terms and
Outdated revenue cycle processes are more than just a nuisance — they’re a liability. Manual workflows, siloed systems, and paper-based tasks drain valuable resources and delay reimbursements, creating frustration for staff and patients alike. Your practice has likely faced mounting pressure to modernize your organization’s operations. And nowhere is that modernization more urgently needed than
Smart Ways to Use Tech in Revenue Cycle Management Read More »
The healthcare industry is facing a significant crisis: a shortage of providers. This shortage has far-reaching effects, not just on patient care but also on the financial health of healthcare organizations. From delayed revenue to overworked staff, the ripple effects of fewer providers are being felt across the board. Here’s why it’s more than just
Provider Shortages: A Crisis Impacting Revenue & Patient Access Read More »
Behavioral health revenue cycle management (RCM) has many unique challenges that can significantly impact cash flow and operational efficiency. There are several levels of care, including outpatient treatment, detox services, intensive outpatient programs (IOP), partial hospitalization programs (PHP), and residential treatment facilities (RTF). Managing the behavioral health revenue cycle needs more than a standard approach.
Reforming Prior Auth: A Turning PointSeen by many as crucial to efficient healthcare delivery and timely reimbursement, prior authorization reform is gaining momentum—and providers need to be ready. Will 2025 Be the Year We Fix the Prior Authorization Delays? In the ever-evolving world of healthcare reimbursement, prior authorization delays have become one of the most
Denied claims can be a major roadblock in the revenue cycle processes of any healthcare organization. In a 2024 report, 38% of survey respondents said at least one in ten claims is denied. It is not unusual for an organization to see claims denied more than 15% of the time! Why does this matter? Well,
Mastering Denied Claims: A Step-by-Step Recovery Guide Read More »
