Healthcare Revenue Cycle Trends to Watch in 2019

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Healthcare Revenue Cycle Trends to Watch in
2019
The revenue cycle process and its management have
continuously progressed over the last few years
to keep up with the changes occurring in the
healthcare industry. 2018 is no exception. When
we talk about health care units and hospitals,
the primary thought that comes to ones mind is
the patient care experience as it relates to
individual health and wellness. However, another
valid part of this business is the seamless
running of the finances, which involves the
revenue cycle management and medical billing. The
moment a patient schedules an appointment with
you, they enter into an ecosystem of payment and
processes and that journey ends when claims are
filed and patient payments have been reimbursed,
either from the patient or from their insurance
payer. This on the outright sounds like a
simple and linear process, but its much more
complicated. To help you organize these financial
processes in 2019, most organizations in the
coming year will depend on healthcare revenue
cycle management experts and software systems to
break down all the patient data influx.
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Healthcare Revenue Cycle Trends to Watch in
2019
Here are some trends to watch out for Payers
will continue to look at ways to cut
costs Insurers have created healthcare policies,
designed plans and tightened provider networks to
cut down healthcare costs and they have shown
success in 2018. As a professional medical
billing and RCM experts, our advice is to expect
payers to accelerate those programs and policies
and search for more some cost-cutting techniques
in 2019. For hospitals and healthcare
facilities looking for ways to improve their
bottom line, many clinicians viewed imaging as a
way to make up for lost dollars and elsewhere.
However, experts also say that payers message
was that medical necessity is the stronger
consideration and that unit pricing needs to
reflect broader market pricing. Many providers
had earlier turned this under-regulated service
line into a profit center, but regulatory actions
made it clear that such activities would not be
acceptable.
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Healthcare Revenue Cycle Trends to Watch in
2019
Organizations will continue to improve denial and
reimbursement settlements Claim denials and
documentation to support reimbursement appeals
are the core regions where the revenue cycle
management continues to struggle. Small, large,
solo or Ambulatory all are seeking innovative
ways to improve the RCM processes and reduce
denial rates, which is via third-party systems,
or (if possible) within the host
system. Training and adoption for the new
systems As the healthcare industry transits
from a legacy to a new and modern system, what it
needs to consider is how to handle the change of
process management for their staff. Some offices
have been using modern systems for more than 10
years now. As proper training and adoption given
by the employer is what propelled this successful
transformation, expect the same in 2019.
Healthcare industry will rely on outside
expertise in 2019 As the industry integrates
into the new system and implement changes, a
vital recipe for success is to contract experts
in the field who understand the technical and
operational characteristics of the software and
the revenue management processes.
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Healthcare Revenue Cycle Trends to Watch in
2019
Its very valuable to work with an experienced
revenue cycle management organization that
employs real consultants and people who have
worked in industry and possess the know-how of
the unique challenges of implementing revenue
cycle solutions. We all have unique perspectives
and experiences that our experts bring to the
table thanks to a verified billing and coding
approach. Cost and Quality Transparency Patient
s are demanding more healthcare cost data on
services given. A recent Financial Patient Survey
found out that 75 of healthcare consumers agree
that its very important to know reimbursements
rates before treatment.   Provider and Payer
partnerships Payers in 2018 have pushed more
cost controls that are now impacting provider
bottom lines, but in 2019 this partnership should
not be turned one-sided. In 2018 there have been
some moments when payers and providers have seen
eye-to-eye. Both of them have increasingly worked
collaboratively. If you are interested in
learning some more insights about our revenue
cycle management and medical billing services,
reach out to one of our experts here.