Revenue Cycle Management


This section includes coverage on the many facets of the revenue cycle food chain for hospitals and physician group practices. Topics span insurance eligibility, charge capture, claims coding, claims submissions, claims clearinghouses, and back-end follow-up with insurance companies to rectify claims denials and resubmission requests.


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Clearinghouse Gateway EDI Buys NHXS

Joseph Goedert | May 15
Gateway EDI, a veteran national claims clearinghouse, has acquired NHXS, a revenue cycle management software vendor serving physician practices. Terms of the acquisition were not disclosed.
Electronic Data Interchange
Revenue Cycle & Payments
Group Practices
Vendor News
Payers

Why ACOs Will Be Different

Gary Baldwin | May 15
Two presenters at the Health 2.0 conference in Boston assert that, unlike the managed care payment models of the past, accountable care organizations have a much better chance of success.
Revenue Cycle & Payments
Disease Management
Chronic Care
Health Info Exchange
EHR
Group Practices
Hospitals
Payers
Policy & Regulation

AMA: Postpone ICD-10 At Least Two Years

Joseph Goedert | May 14
The ICD-10 compliance date should, at minimum, be pushed back two years to Oct. 1, 2015, the American Medical Association contends in a comment letter to the Centers for Medicare and Medicaid Services.
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Coding
Electronic Data Interchange
EHR
Group Practices
Hospitals
Payers
Policy & Regulation

Association for HIT Leaders Comments on ICD-10

Joseph Goedert | May 14
The College of Healthcare Information Management Executives, in a comment letter, expresses support for the government’s decision to delay ICD-10 implementation to October 2014.
Coding
EHR
Decision Support
Group Practices
Hospitals
Revenue Cycle & Payments
Policy & Regulation
Payers

IRS Notices Address Employer Pay-or-Play Under Reform

Edward I. Leeds & Clifford J. Schoner | May 11
In a series of three notices, the IRS has signaled the approach that it may take on certain key issues arising under the employer shared responsibility, or "pay or play,” provisions of the Affordable Care Act and is seeking comment on these and other questions. All of the matters discussed in the notices will ultimately be addressed in regulations.
Payers
Policy & Regulation

AHIMA Comments on Rule to Delay ICD-10

Joseph Goedert | May 09
The American Health Information Management association, in a comment letter on the April 17 proposed rule to delay ICD-10 implementation by one year, seeks guarantees that there will not be further deadline extensions.
Coding
EHR
Policy & Regulation
Group Practices
Document Management
Hospitals

Health I.T. Vendor Round-up: Allscripts, Rapid Insight, PracticeMax & EHR Doctors

Joseph Goedert | May 09
An acquisition, new analytics software, a Texas-sized health information exchange agreement and a little self-preservation highlight recent health information technology vendor news:
Group Practices
EHR
Practice Management
Vendor News
Health Info Exchange

Emdeon Buy Targets Payers, Payment Integrity

Joseph Goedert | May 07
Revenue cycle management vendor Emdeon Inc. has acquired TC3 Health Inc., a vendor of cost containment and payment integrity software.
Revenue Cycle & Payments
Payers
Electronic Data Interchange
Vendor News

Three Firms Seeking Class-Action Lawsuits Against Allscripts

Joseph Goedert | May 03
At least three law firms have filed shareholder lawsuits seeking class action status against hospital/physician software vendor Allscripts following poor first quarter financial results and the departure of several senior executives.
Vendor News
Group Practices
Hospitals
EHR

AMA Pushes E-Billing of Workers’ Comp Claims

Joseph Goedert | May 01
The American Medical Association is supporting a state rule that encourages electronic processing of workers’ compensation claims.
Electronic Data Interchange
Group Practices
Revenue Cycle & Payments
Policy & Regulation

Top HIS Vendors by 2011 Revenue

Vince Ciotti, Barry Mathis and Elise Ames, HIS Professionals LLC | May 01
Ever wonder how your hospital information system vendor ranks in annual revenue?
EHR
Hospitals
Vendor News

The Virtues of Virtualization

Greg Gillespie | May 01
There are potentially many virtues of data virtualization, but saving money isn't necessarily one of them.
EHR
Decision Support
Payers
Hospitals
Group Practices
Policy & Regulation
Revenue Cycle & Payments

CPSI Results Mixed, but Stock Up

Joseph Goedert | Apr 27
Community hospital information systems vendor Computer Programs and Systems Inc. saw its stock price increase on April 27 despite mixed financial results for the first quarter of 2012.
Vendor News
EHR
Hospitals

HIT Vendor Round-up: NextGen, IVANS, Relay Health & NTT DATA

Joseph Goedert | Apr 25
Health information technology vendors have recently announced new initiatives including acquisitions, discounted purchasing opportunities and customer wins
EHR
Group Practices
Practice Management
Electronic Data Interchange
Revenue Cycle & Payments
Health Info Exchange

Rule Tightens NPI Use for Medicare/Medicaid

Joseph Goedert | Apr 24
The Centers for Medicare and Medicaid Services has issued a final rule tightening requirements for providers and suppliers to use a national provider identifier.
Policy & Regulation
Group Practices
Hospitals
Electronic Data Interchange
Revenue Cycle & Payments
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The Price of I.T. Progress?

Looking to build better care coordination, health systems are buying physician groups in droves. Making the deal work, however, requires careful management on the I.T. front.

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