Revenue Cycle Management

Two years after a historic health care cyberattack exposed dangerous single-point failures in claims routing, the industry has largely rebuilt the same vulnerable structure.

From clean claim rates to contract negotiations, these warning signs could mean your practice is leaving thousands in revenue uncollected.

Revenue cycle consultant Kem Tolliver says practices that bring frustration instead of data to payer disputes will keep losing ground.

Small practices may be missing thousands of dollars in Medicare revenue monthly. Here are 6 billing opportunities that don't require new patients or more hours.

Stop reacting to denials: proactive, data-driven tactics to cut payer friction, prevent revenue leakage and improve cash flow.

Independent practices can win payer negotiations, but preparation is everything. Doral Jacobsen of Prosper Beyond VBC explains how.

Cut claim denials and speed cash flow with smarter intake, clean claims, EFT/ERA automation and patient-friendly billing metrics.

Health care payments still feel fragmented; cross-team alignment unifies billing channels, tokenized methods and workflows to boost completion rates and reduce patient frustration.

Replace lagging revenue cycle metrics with labor-effectiveness benchmarks, AI automation, prereg fixes and vendor transparency to boost margins by 2026.

Medical practices face significant revenue loss from denials and appeals, but improved front-end processes and coding accuracy can help.

Healthcare costs soar as hospitals charge more for identical services than independent practices. Site neutral payment reform promises savings and better access to care.

Health care practices enhance revenue by collaborating with payers for digital out-of-pocket payments, improving cash flow and patient engagement.

Medicare's new APCM codes empower primary care providers to bill for complex patient management without time constraints, enhancing chronic care delivery.

Step therapy protocols not only delays necessary treatment but can lead to adverse reactions that ultimately increase rather than lower health care costs.

Given that so much of the high costs associated with running a healthcare business remains outside of the organization’s control, financial leaders will have to consider how they can impact the one area that is in their control in 2025: reducing administrative waste.

Behind today's high denial rates lies a fundamental tension – coding requirements grow increasingly complex as coding resources lessen.

Medical professionals use advanced technology to deliver optimal patient care on the frontline, but data shows that many business offices in the healthcare industry are hesitant to do the same.

Specialty providers can take steps now to succeed with MIPS and VBC while prioritizing caring for their patients.

With the right strategies, independent practices can ensure they are financially sustainable while continuing to provide high-quality care to their patients.

To help practices prepare for their value-based care transition, here are three top considerations for success.

Generation Z is driving changes to patient engagement and payment.

Navigating payer denials requires the most expertise to handle within revenue cycle management

Cash-based health care is a win-win for vulnerable groups and primary care providers.

Outsourcing allows doctors to focus on patients instead of billing

How net revenue forecasting can give health leaders financial x-ray vision