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The Role of Automation in Enhancing Eligibility Verification for RCM

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As healthcare systems grapple with workforce shortages and staff burnout, maintaining a delicate balance between operations and the revenue cycle is becoming a mammoth task for them, especially when their processes are mostly labor-intensive. Adding to their woes are payer denials and eroding margins, often resulting from front-end inefficiencies during patient eligibility verification and prior authorization. The situation is, thus, prompting providers to pivot toward technologies like artificial intelligence (AI) and robotic process automation (RPA) for revenue cycle management (RCM). Explore this blog to uncover industry insights into RPA adoption; challenges associated with manual eligibility verification; benefits of implementing automation at the front-end process of RCM; and how Jindal Healthcare’s RPA-powered patient eligibility verification solution can help providers improve patient access. What industry insights tell about RPA adoption The 2021 survey by Becker’s Healthcare ...
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Denial Management Workflows: A Step-by-Step Approach to Boost Revenue

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The “National Hospital Flash Report: April 2023” indicates that US healthcare providers are struggling with more denials of claims. This problem influences patient treatment and happiness in addition to the financial viability of healthcare companies. Healthcare Denial Management providers have to aggressively simplify their revenue cycle handling system if they want to meet these obstacles. Healthcare providers use this financial system for tracking, billing, and payment collecting of incoming payments. Research and Markets’ projections indicate that by 2030, the RCM market is expected to reach US$238 billion. Today, we will discuss denial management in healthcare; first, you must know the moving elements before starting denial management. What is Denial Management in Healthcare  When a healthcare insurance payer declines to compensate a physician for services delivered to a patient based on their benefits, a claim denial results. A denial of a claim could have hundreds of differe...
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Location: Houston, TX, USA
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Utilizing AI in Denial Management to Enhance Revenue Cycle Management Efficiency

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Claim denials continue to be one of the most dreaded setbacks for healthcare providers, tormenting their revenue cycle and costing them a staggering  $20 billion  every year. With around $43.84 as the average cost of fighting a claim, the stakes keep getting higher. Shifting payer behavior, fewer hands on deck to deal with the rising patient and claim volume, and heavy reliance on manual claims management result in process inefficiencies and revenue leaks, further adding to their woes. However, there’s some good news:  about 90% of the denials can be prevented  and around 63% can be recovered on appeal. Artificial intelligence (AI) in denial management can be a game-changer for healthcare revenue cycle management (RCM) in this regard.  AI is fast becoming the most sought-after technological aid among healthcare providers to boost operational efficiency through evidence-based process improvements. It has successfully helped digitally transform practices end-to-en...
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Location: Houston, TX, USA
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What is Revenue Cycle Management in Healthcare?

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Inside this Article: Revenue Cycle Management: Definition Why Need a Revenue Cycle Management? Why is Revenue Cycle Management Important in Healthcare? What are the Significant Stages in Revenue Cycle Management?   Revenue cycle management Company The board (RCM) in medical services is the interaction that tracks and deals with the monetary parts of patient consideration, from when a patient registers and timetables an arrangement to when the last installment is made. The objective of RCM is to distinguish, make due, and gather patient help income effectively. It envelops all that from deciding patient qualification, gathering co-pays, coding claims appropriately, following cases, gathering installments, and circling back to denied claims. Productive RCM guarantees ideal repayment for administrations delivered, limiting charging mistakes and decreasing the time between administration conveyance and installment receipt. This cycle is basic for...
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What is revenue cycle management?

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Inside this Article: What is an RCM vendor? What are the steps of the revenue cycle in healthcare? Which RCM vendor had the highest install volume? What is the overall goal of revenue cycle management?   Revenue cycle management Company of the executives is precisely the exact thing it seems like — a system that medical care associations can use to deal with the regulatory and clinical cycles in their Revenue cycle management Company. This includes handling claims, gathering patient installment, speaking with health care coverage payors, and that's only the tip of the iceberg. What is an RCM vendor? While the Revenue cycle management Company the board interaction should be possible physically, the intricacy of the means associated with the cycle actually intends that there are numerous open doors for exorbitant mistakes to happen. In-house RCM groups can likewise be a costly speculation, as the medical organization should recruit and...
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