Regulatory/Change Management
How should health systems implement new medical debt or price transparency regulations?
New revenue cycle regulation should be treated as a cross-functional change management program, not a policy update. The sequence operators use: inter…
AI
Where should AI be used in the revenue cycle - and where shouldn't it?
AI belongs on the repetitive, transactional layer of the revenue cycle: routing accounts to work queues, updating addresses, retrieving statement bala…
Leadership
How Long Should New Hire Training Be in Patient Financial Services? A Benchmark for RCM Leaders
Effective patient financial services (PFS) training runs three to four weeks and combines classroom instruction, department-specific learning, case st…
AI
How should health systems evaluate AI vendors for revenue cycle?
Health systems should evaluate AI revenue cycle vendors against the administrative cost problem they are meant to solve, not against generic productiv…
Leadership
How do you break down silos in revenue cycle operations?
Breaking down silos in revenue cycle isn't a culture initiative - it's an operating model decision. The work isn't a linear series of handoffs from ac…
Leadership
What does 'right seat, right person' mean in revenue cycle leadership?
In revenue cycle, "right seat, right person" does not just mean matching a manager's skills to a job description. Sharlene Seidman, VP of Revenue Cycl…
Denials Management
How can revenue cycle teams reduce authorization denials in real time?
Move authorization variance detection out of the back office and into the procedural area itself. When a circulating nurse transmits the actual item o…
Denials Management
What is the difference between preventable and unpreventable authorization denials?
Preventable authorization denials originate from controllable operational touchpoints inside the provider organization: preference card adherence, sup…
Revenue Cycle Management
How should an RCM leader gain access to clinical departments for process improvement?
To gain meaningful access to clinical departments, an RCM leader needs three things: explicit air cover from a senior leader who can open the door, a …
Denials Management
What is the root cause of most authorization denials in surgical departments?
Many surgical authorization denials do not originate from payer behavior, coding errors, or a lack of knowledge about the authorization on file. They …