Healthcarercm

Those considering   offshoring their RCM   may have questions about setting their teams up for success. The right partner will ease any concerns and instill confidence in your team by leveraging commonly used project management tools and engaging in open, honest communication. When considering the life cycle of the engagement, here are some best practices you should watch for. Once you’ve decided to  outsource rcm services , you and your outsourcing partner should work together to: Clearly Define the Scope of Work in the RFP:  Defining the scope of work helps to eliminate any ambiguity. For example, with A/R, what range would the RCM team work? When considering the services you expect from your RCM partner, what’s in scope? Who is responsible on the customer and vendor sides? This is also a great time to define volumes so both teams can staff appropriately. Define and Document RCM Partner Capabilities:  During contracting discussions, it is essential to fully as...

  Labor shortages present significant challenges for healthcare organizations, which have been intensified by the COVID-19 pandemic. Nearly two-thirds of healthcare facilities are understaffed, resulting in decreased data quality, slower claims processing, increased claim denials, increased workload, burnout among existing staff members, and higher turnover rates. An AHIMA survey report as of October 1, 2023, indicates the U.S. experienced a 66% shortage of health information professionals (HIM) for the last two years due to the great resignation, an increase in growth demand, and an increase in the aging population in the U.S healthcare industry. Data from the Bureau of Labor Statistics (BLS) estimates that  healthcare jobs are expected to grow 13%  through 2031. Approximately 83% of HIM staff are distributed between revenue cycle management (RCM), coding and billing, and medical record administration, suggesting an even higher concentration of a shortage of staffing in ...

  Accuracy and efficiency of coding and documentation are crucial for successful revenue cycle management (RCM) and to ensure optimal reimbursement. Applying technology to  mid-cycle RCM  operations enhances the quality of  clinical documentation improvement (CDI)  and coding processes. This article explores the tools and strategies that are reshaping the way healthcare organizations enhance documentation quality, streamline coding workflows, and maximize revenue capture. Technology in Clinical Documentation Improvement Worklist Prioritization Effective worklist prioritization strategies are necessary to maximize the efficiency and impact of CDI efforts. Traditionally, a discrepancy in the number of CDI specialists compared to the overall patient population has led to the adoption of a sampling approach to documentation, where only a subset of patient records is reviewed. This method, however, results in a considerable number of missed opportunities for queries,...