Nearterm Blog

PCMH vs. ACO

PCMH vs. ACO in Healthcare – Which is Best?

Many healthcare providers are facing the rising costs of providing medical care. These include drug, material, education, and other expenses.  At the same time, insurance costs for patients are also rapidly increasing. Deciding how to provide medical care in the most efficient and cost-effective ways is becoming an increasingly complex healthcare management issue. In tandem…

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what is revenue cycle management in healthcare?

Why Is Revenue Cycle Management Important in the Healthcare Industry?

Revenue Cycle Management (RCM) plays an important role in the healthcare industry. Managing revenue is vital for any business but may not be the primary focus of healthcare providers. However, these providers need revenue to pay for medical supplies, salaries, equipment, and more. Healthcare costs are increasing with technology adoption in a time when an…

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what is medical health information management

What is Health Information Management & Why Is It Important?

Individuals involved in healthcare around the world acquire and generate a significant amount of personal health information about patients. The scope of health information includes not only personal information and private health data, but also associated payment forms and transactions. Clinical notes, pharmacy, and outpatient care records are also covered health information. As technology has…

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physician revenue cycle metrics

Top Revenue Cycle Key Performance Indicators

Healthcare organizations must manage their revenue cycle with an approach that balances patient care and quality. Due to increasing medical and drug costs paired with higher insurance premiums and deductibles, efficient revenue cycle management (RCM) is more important than ever. There are many indicators one could use to gauge the effectiveness of various elements of…

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what is a healthcare clearinghouse?

What is a Healthcare Clearinghouse & Why Use One?

Modern medicine in the United States includes a complex relationship between healthcare providers and insurance payers. Technology plays a critical role in electronic data interchange (EDI) between payers and providers, but the wide variety of software systems used can make seamless connection difficult. The Health Insurance Portability and Accounting Act (HIPAA) addresses the importance of…

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current healthcare management issues

Current Issues in Healthcare Administration and Management

There are many healthcare management challenges in the U.S. today. Some of these problems have evolved slowly overtime as a result of growing, complex, and diverse healthcare offerings. Rising costs in almost every area have been impacting hospitals and other healthcare providers as well as patient willingness to seek care. Regulatory changes have also introduced…

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SILENT IMPRESSIONS

Every encounter we have with another person or a business results in an impression. An encounter may be conversation, email, voicemail, text, social media, appearance, hygiene and others. Some of the impressions we form based on these encounters are stronger than others and because people are all different, reactions vary. Some impressions are indelible and…

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denial management in healthcare

Improving Denial Management in Healthcare & Medical Billing

When insurers deny medical claims, it takes a bite out of your revenue every year. Nationwide, this annual loss amounts to $262 billion, according to Modern Healthcare. As a matter of fact, insurers deny an average of 9 percent of claims overall, which means that your staff is engaged in a continual process of managing and appealing…

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Revenue Integrity & Capture – Who’s Herding the Cats?

Cross functional processes can be difficult to manage in hospitals. One reason pertinent to Revenue Integrity is that typically, the organization structure is a series of vertical disciplines with differently defined focus (HIM, PFS, PATIENT ACCESS, ANCILLARY DEPARTMENTS, MD’s, et.al.). This structure can be and is very effective in many hospitals. However, revenue integrity management…

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