PLYMOUTH, Mass., Dec. 13, 2016 /PRNewswire/ -- Where do the hospitals turn when insurance claims are unresolved and the clock is ticking? Healthcare Revenue Strategies (HRS) has unveiled a new website designed to assist healthcare organizations in dealing with "increasing complexities in claims" which, unresolved, cripple their overall performance and increase costs to patients.
Welcome to the world of denial management— a critical stage in the billing process that hospitals and other healthcare providers are often ill-equipped to handle efficiently on their own. The typical consumer is likely unaware of this specialty and the impact it may have on the revenues of hospitals and other medical providers. The bottom line is that resolving issues with insurers is ongoing and that professionals like HRC are called in to make sure those claims are paid on behalf of patients.
Healthcare Revenue Strategies, through its website, offers a glimpse into this complex world of financial management, helping both patients and providers understand how critical their expertise is in the world of healthcare financial management. HIPAA (Health Insurance Portability and Accountability Act) regulations make it even more complicated and create more restrictions for healthcare organizations in resolving insurance claims.
Errors in processing medical claims alone cost the healthcare system in the United States billions of dollars every year. Failure to follow up properly on claims that are denied or put on hold is also a huge factor in claims being paid in full instead of getting lost in a stampede of claim denials. Revenue efficiency simply means that healthcare organizations get what is owed to them through the coverage of their patients.
Denial management is essentially about timely response. Issues have to be identified and corrective actions taken. That ticking clock is set in motion by insurers who give healthcare providers just so many days to respond before claims are denied, even if it is just a matter of clarification or a procedural flaw. Specialists like HRS, which has been enhancing hospital revenue performance for 20 years, partner with hospitals "in the effective management of revenues, claim generation and remittance analysis."
Some detective work is required, because it is critical to find out why claims are being denied and, based on that knowledge, making sure more claims are paid with the first submission. Expert analysis of electronic health records reveals that claim denials often show up as trends that can be identified and resolved, saving time and increasing revenues.
Managing and maximizing revenues for hospitals is more than denial management. It is also about bringing in the right personnel, services and tools for the effective oversight of all revenues, overseeing those electronic health records, notably as a MEDITECH consultant, and ensuring that patient medical histories are accurate and compatible with records in the files of physicians who have treated these patients.
To learn more about denial management and other hospital revenue issues, visit the new mobile friendly HRS website at www.hrsrevcycle.com, with updated news to better serve its clients.
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SOURCE Healthcare Revenue Strategies