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Category: Revenue Cycle Management

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November 16, 2022

3 Compelling Reasons that Buying Prior Authorization Software Blows Away Building It from the Ground Up

by Susan Lawson-Dawson | Prior Authorization, Revenue Cycle Management

“Rising demand for centralization and streamlining of healthcare administration is also anticipated to drive the market for electronic health records,” writes Grand View Research in its market analysis on EHR solutions.  Healthcare revenue cycle providers face a similarly rosy picture for market growth. But the potential for growth also means increased competition.  Integrating prior authorization software in your platform could be a force multiplier for your business. Why? Take a look in our eBook: The Build vs. Buy Decision or read on for a sneak peak at some of the topics covered. .  Your Customers Want & Need It Prior… Read entire article here

November 16, 2022

Prior Authorization Your Nemesis? Superhero Strategies for Vanquishing Delays & Denials

by Susan Lawson-Dawson | Prior Authorization, Revenue Cycle Management

After months of media buzz, one of the most anticipated superhero movies of 2022 hit theaters over the weekend—and by all accounts delivered a heroic performance at the box office. It got us thinking. How can healthcare providers apply superhero traits to beat prior authorization challenges?  Staffing & Financial Impact of Delays & Denials  In a November report and infographic, the American Hospital Association states, “Inappropriate prior authorization and payment denials result in significant disruption for hospitals and health systems, challenging their ability to continue caring for their communities.” The survey of 772 hospitals and health systems reveals the burdens… Read entire article here

November 7, 2022

Indisputable Hurdles to Getting Every Dollar Owed … Unless You Have Prior Authorization Software

by Susan Lawson-Dawson | Prior Authorization, Revenue Cycle Management

The pressures healthcare providers face haven’t eased up this year. Northern Arizona Healthcare CFO Clifford F. Loader told HealthLeaders in July that “The after-effects of the pandemic—such as a general shortage of healthcare providers such as doctors and nurses, and continuing inflation in the pricing of medical supplies and pharmaceuticals—are ongoing. With no further funds anticipated, the healthcare industry is facing adverse financial impacts."  Is it any wonder that many healthcare providers are looking for ways to stabilize their revenue cycles. Prior authorization software can help, especially when it comes to getting reimbursed (by payers and patients).  Lack of patient… Read entire article here

August 19, 2022

Hold on Tight: Waves of Healthcare Regulations Ahead in Effort to Solve Prior Authorization Woes

by Susan Lawson-Dawson | Prior Authorization, Revenue Cycle Management

“A swelling tsunami of information.” That’s how the Journal of AHIMA described the ongoing surge of legislation and guidance for interoperability. Improving data exchange addresses administrative burdens like prior authorization. During a recent panel discussion with post-acute care providers, we asked for their take on current and proposed laws. What’s promising? What’s not? Let’s start with an approach that’s viewed as a mixed bag. Gold Carding to Reduce Prior Authorization Burden Gold carding refers to the practice of exempting providers from seeking prior authorization of a service IF they have an acceptable approval rating over a specific time period. The… Read entire article here