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Revenue Cycle Management

Unraveling the RCM Maze in Behavioral Health

Leave a Comment / Benefits of Outsourcing, Consulting Services, Mental Health, Revenue Cycle Management, Revenue Cycle Matters /

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. […]

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Prior Authorization Reform

Reforming Prior Auths: A Turning Point

Leave a Comment / Consulting Services, Healthcare Consulting, Industry News, Revenue Cycle Management, Revenue Cycle Matters, Technology in Healthcare, Uncategorized, Updates /

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

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Mastering Denied Claims: A Step-by-Step Recovery Guide

Leave a Comment / Business, Consulting Services, Healthcare Consulting, Increased Cash Flow, Medical Billing, Medicare Reimbursement, Payor Contracting, Process Improvement, Provider Enrollment or Credentialing Services, Reimbursement Analysis, Revenue Cycle Management, Revenue Cycle Matters /

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,

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Navigating 2025 Reimbursement Changes: What Providers Need to Know

Leave a Comment / Data Analytics, Healthcare Consulting, Increased Cash Flow, Medical Billing, Medicare Reimbursement, Payor Contracting, Process Improvement, Provider Enrollment or Credentialing Services, Reimbursement Analysis, Revenue Cycle Management, Technology in Healthcare /

Navigating 2025 Reimbursement Changes: What Providers Need to Know As most of you are probably aware, Medicare has implemented several changes affecting specialists’ reimbursement, primarily through adjustments to the Medicare Physician Fee Schedule (MPFS). The Centers for Medicare & Medicaid Services (CMS) have released a conversion factor of $32.35 for the calendar year (CY) 2025,

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