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Healthcare Claims Data Analytics: The Proven Tool for Maximizing Payer Reimbursement
Read about the 8 concrete benefits of using healthcare claims data analytics. Use data and insights to maximize revenue.

Provider Appeal Letter Sample for Prior Authorization, Medical Necessity, and Untimely Filing Denials
findUse these provider appeal letters for prior authorization, medical necessity, and untimely filing denials. Get your denial overturn rate up and become your organization’s golden goose.

Healthcare Claims Management Software
Review the features and advantages healthcare claims management software can bring to your organization. Rising healthcare denial rates must be countered.

Healthcare RCM Platform: Integration with your EHR and other technology
Review the 4 steps in successful healthcare RCM platform integration with the EHR and other technology.

Chargemaster Maintenance: Identifying and Fixing Rates Set Below Payer Allowables
Review what chargemaster maintenance involves and how your healthcare peers making sure they keep the chargemaster accurate and up-to-date all year.

How to Negotiate Reimbursement Rates with Insurance Companies
Providers are done passively accepting unfavorable payer rate and term changes. Review how to negotiate better reimbursement rates with insurance companies.

Insurance Contract Negotiation Services: Pros and Cons
Review the pros and cons of insurance contract negotiation services so you can determine whether they are the right fit for your organization.

Managed Care Contracts: How Providers Pull More Revenue Back from Payers
To take a proactive approach to scrutinizing and optimizing managed care contracts so you can capture the revenue your healthcare organization has earned.

Denial Recovery: Why Providers Must Find Opportunity by Allowables (Not Charges) & More
Review the biggest challenges to denial recovery and the strategies that overcome them.

Payer Policy Changes: How Providers Catch Updates on Time to Avoid Denials
Review how to improve your first-pass rate, reduce your denials, and improve your revenue long-term by having a payer policy changes management plan.
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Payer Price Transparency: Use it to Increase Rates & Revenue
Payers have tried to obfuscate their price transparency machine-readable files (MRFs). Review how you can get the data inside to see which payer brings the most value.

Bundled Payments in Healthcare: Challenges and Opportunities
Provider groups, and healthcare MSOs must find ways to approach expanding bundled payment (BPCI) challenges while leveraging the opportunities

Payer Rates: How Providers Elevate Them Meaningfully
Discover how to use data, benchmarking, and technology to justify your requested increases to payer rates so that your margins improve.
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RCM Outsourcing: Why Keeping Revenue Cycle In-House is Better
Review the pros and cons involved in RCM outsourcing as well as the sometimes-overlooked benefits of keeping revenue cycle management in-house.

Claims Workflow: 8 Best Practices To Limit Denials And Underpayments
Discover the 8 best practices in the claims workflows that can transform your denial rates and boost your bottom line

Payer Downcoding: 10 Tips to Avoid It
Review the nuances of payer downcoding and the ways providers can prevent them.

Navigating Provider Growth: Strategies for MSOs
For MSOs, carefully navigating provider growth starts with a focus on stablization before determining staffing, capital, and operational needs.

RCM Health Information Management: 3 Ways Switching from Manual to Automated Improves Revenue
Deliver key insights and data to CFOs and other C-suite executives quickly and accurately by using automated RCM health information management.

RCM Vendor Evaluation: Drive the Demo with this Checklist
Take control of the revenue cycle management vendor evaluation. Prepare for the demo with this checklist that gets them to prove their value.
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Healthcare Reimbursement System: How to Use EAPG, APG, and More Classifications Accurately to Optimize Revenue
EAPG, APG, DRG, and more grouping classifications can get confusing. But accurate use can improve healthcare organization revenue. Read how here.

Payer Contract Modeling: How Providers Model Changes To Negotiate Better Reimbursement Rates
Use contract modeling to grasp the full revenue impact of proposed payer changes, determine best payers, and back up your negotiation position with data.

RCM for Ophthalmology: Your 4 Biggest Revenue Cycle Challenges Solved
Review how advanced RCM for ophthalmology helps ophthalmologists overcome challenges, improve revenue and contain costs to collect.

Healthcare Contract Management Platform: How Automation Beats An Internal Contract Manager
Review the advantages and pitfalls of hiring an internal contract manager or using an automated healthcare contract management platform.

RCM for Radiology: 21 Tactics to Optimize Revenue
Radiology has unique revenue cycle challenges. Review 21 tactics for vanquishing any pitfalls involved in RCM for radiology.

Clean Claims in Medical Billing: 6 Innovations for Exceptional Accuracy
Payers use AI, ML, NLP and more to limit reimbursements. Providers can the same advanced technologies to achieve clean claims in medical billing.

RCM for Orthopedics: 17 Tactics to Optimize the Revenue Cycle
Orthopedics physician groups and MSOs can fix specialty-specific revenue cycle challenges when they use these 17 revenue repair tactics.

Payer Management for Providers: How to Optimize Contracts to Prevail Over Payers
Payer management takes dedicated oversight. You can increase your negotiating power with these proven tactics.

Claims Reprocessing: Best Practices to Improve Recovery of Denials & Underpayments
Read about the intricacies of claims reprocessing. Explore best practices to improve underpayment and denials recovery and streamline your revenue cycle.

Healthcare Contract Compliance: 9 Ways Contract Management Software Helps Keep Providers Compliant
Breaching federal healthcare contract compliance rules gets expensive. Discover all the ways contract management software keeps healthcare organizations compliant.

Healthcare Payer Intelligence: How Providers Can Make Data-Driven RCM Improvements
Win staff and superior buy-in when you propose ideas based on payer intelligence derived from operational data. Read how you can improve revenue with payer intelligence.

Fee Schedule Reimbursement: What MSOs Can Do When It Falls Short
If fee schedule reimbursement is falling short, healthcare organizations have many remedies.

Revenue Cycle Operations: 4 Approaches MSOs Can Use to Enhance RCM
Proactive revenue cycle operations management puts up the guardrails for MSOs, keeping you in control.

Revenue Cycle Processes: Best Practices to Streamline RCM
The 12 revenue cycle processes have many steps involved in each. Read how you can simplify and streamline them to optimize your revenue cycle.

Revenue Cycle Reports: Key Intelligence to Optimize RCM
Reliable revenue cycle reports help RCM leaders improve revenue and gain control over organization margins, operations, and compliance.

Denial Management Process: 8 Steps to Improve Healthcare Providers’ Margins
A rigorous denial management process improves healthcare margins and operations. Simplify yours with this guidance.

Revenue Cycle Performance: 5 Advanced Tactics to Improve Healthcare RCM
Heatlhcare is undergoing a digital transformation driven by advanced AI and automation-driven technologies. Read how to unleash the most advanced tactics to improve revenue cycle performance.

Multiple Procedure Payment Reductions: How to Stop Them from Draining Provider Revenue
Multiple Procedure Payment Reductions (MPPRs) sap healthcare organization revenue. Use these best practices to limit them.

MSO Underpayments: How to Uncover Hidden Revenue
As an MSO, you can impress PE investors when you identify underpayments and insist that payers reimburse per the exact amounts agreed to in your contracts.

MSO Recapitalization: Leverage Underpayments and More to Appeal to Private Equity Investors
Eager to enter healthcare, Private Equity is looking for MSO recapitalization opportunities. Review how to use recapitalization to connect.

Medical Claims Appeal Processes: How Healthcare MSOs Can Streamline
54% of private payer denials are ultimately overturned. MSOs can tame the appeals process by integrating all platforms and using automation and AI.

Contract Management Integrations: 11 Obstacles Providers Can Easily Overcome
Review how to overcome each challenge in contract management integration so your MSO or provider group can become a digitized, modernized 21st century digital healthcare system.

Automated Healthcare Solutions: Where Are You in Streamlining RCM Processes?
It's past time to stop the "brute force" manual spreadsheet analysis of your revenue cycle. Read

Healthcare Contracts: How MSOs Can Handle Contract Complexity Across Many Locations
MSOs must create, manage, and monitor payer contracts far more carefully than a physician group or even a health system limited to one state. Review how you can support your portfolio with aggressive contract managment.

Payment Posting: How to Improve this Process to Identify Underpayments
Review the importance of payment posting and the processes to optimize it so that you can enhance revenue cycle efficiency, improve overall financial health.

Real-Time Visibility into Contract Performance: Why & How to Move Away from Manual Review
Discover how you can get the advantages of real-time visitiblity into contract performance when you shift away from time-consuming manual review.
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Payer Contract Audits: Steps to Writing Robust Revenue into Agreements
Set up a contract audit process at your healthcare organization with these steps. Contract audits are crucial for maintaining financial health and uncovering underpayments and unfavorable contract terms.

Decentralized Operations: How MSOs Can Centralize the Revenue Cycle
With numerous acquisitions, management services organizations (MSOs) must reject decentralization and centralize operations to optimize revenue and succeed.
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Revenue Cycle Efficiency: Achieve Productivity and Accuracy in Existing Operations
Explore how you can increase the speed and accuracy of existing revenue cycle operations. Reduce waste and minimize errors in financial, operational, and administrative processes.
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Lesser-of Clauses in Payer Contracts: How to Negotiate and Win
Explore how your healthcare organization can track down, understand, and negotiate lesser-of clauses in payer contracts.
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RCM Data - Find it, Analyze It, and Build On Its Insights for Better Revenue
Discover how to leverage RCM data sources, analytics tools, and expertise to optimize your healthcare revenue cycle. Explore in-house vs. outsourced options for data-driven improvements.

Navigating Payer Relationships: 2 MSO Approaches for Optimal Reimbursement
MSOs can simplify the provider / payer relationship. Explore both collaborative and adversarial approaches that optimize reimbursements, improve negotiations.

Insufficient RCM Staff for Underpayment Recovery? Automation Gets It Done
With limited RCM staff, recovering chronic underpayments can seem impossible. Review how MSOs and physician groups use automation to get this important work done.

Healthcare Chargemaster: Strengthen Your Pricing Foundation to Optimize Revenue
Manage your healthcare chargemaster and limit payer greed. Learn how to optimize revenue through effective people, processes, and technology.

Self-Pay Collections: Establish a System that Benefits Providers & Patients
An upgraded self-pay collection system relies on good faith estimates, patient portals, mobile payment collection, and alternative payment plans to boost your revenue.
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Payer Performance Monitoring: Empowering Data-Driven Negotiations and Decisions
Discover the benefits, best practices, and technologies of payer performance monitoring to optimize revenue cycles and enhance healthcare operations.

Claim-Level Revenue Prediction: Allocate Your Resources with Precise Cash Flow Numbers
Discover how claim-level revenue prediction shores up many aspects of the healthcare revenue cycle. Read how incremental revenue improvements snowball into real money.

Contract Compliance Monitoring: Outmaneuver Payers with This Revenue Recovery Tactic
How to enhance revenue recovery and outmaneuver payers in the competitive healthcare landscape with contract compliance monitoring.

Automate Payer Fee Schedule Management for Higher Margins & Happier Staff
Start exploring how you can automate payer fee schedule management. There’s money in your contracts and fee schedules. Go get it!
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Healthcare Data Integration of Multiple PM Systems: Overcoming a Common MSO Challenge
MSOs struggle with healthcare data integration of multiple PM or EMR systems. Unleash reliable data integration to win future healthcare organization success.

RCM Benchmarks: How Close Does Your MSO Come to These Ideal Measurements?
Cut a clear path to better revenue and workflow efficiency when you benchmark your RCM activities. Review RCM benchmarks here.

Healthcare Contract Lifecycle Management: 7 Stages MSOs Must Optimize
Improving EBITDA takes rigorous healthcare contract lifecycle management. Review how you can shore up every stage in the contract lifecycle here.

Revenue Cycle Improvement: How MSOs Are Finding Cash and Cutting Their Cost to Collect
Achieving revenue cycle improvement is one of the first jobs of a new RCM director or VP. Review this list of every place to unlock healthcare revenue.

Payer Contract Management: How Physician Groups & MSOs Can Push Back on Insurers
MSOs and physician groups can push back on unfavorable payer proposed changes. See how the data from payer contract management empowers you.

Healthcare Fee Schedule and Contract Terms: Reinforce Revenue with These 6 Fixes
Only the utmost accuracy on your healthcare fee schedule and contract terms optimize your revenue. Improve accuracy with these 6 fixes.

EMR Integration After Acquisitions: A Guide for MSOs
Rapidly expanding management services organizations must integrate many different EMRs into their own. Make multiple EMR integration possible with this guide

Healthcare Revenue Intelligence: Revealing the Cash at Each Step of the Revenue Cycle
Reinforce your revenue when you use healthcare revenue intelligence (analytics) to find payer underpayments, registration errors, contract performance data, missed charges and more.
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Healthcare Revenue Recovery: Turn These 7 Challenges into Cash Flow
Strengthen your healthcare balance sheet with more revenue, not staffing cuts. Review these 7 approaches to healthcare revenue recovery.
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Healthcare Payer Analytics: 5 Forms of Analysis that Uncover Revenue Recovery Opportunities
Explore how you can get lucrative insights into each step of your revenue cycle using all five types of healthcare payer analytics.

Medical Practice Integration: A Guide for MSOs
Get a comprehensive overview as well as the critical details involved in medical practice integration. This roadmap gives you a quick start.

Patient Retention Strategies: 5 Approaches to Optimize Revenue
Winning a new patient costs from 5X - 25X more than retaining an existing one. Which of these top 5 patient retention strategies could reinforce your revenue?

Payer Contracting: 4 Steps to Maximizing Provider Reimbursement
When you have accurate data on your payer’s value to you and your value to them, you can negotiate your healthcare contracts with confidences and success.

Payer Strategy: How Provider Groups Can Optimize the Payer Mix
Establish a proactive payer strategy to regain control of your contracts and empower your practice in payer negotiations.

MSO Operations: Follow the Stabilization-Optimization-Growth Model for Success
MSOs that jump to biz dev after practice acquisition risk a physician group not ready for prime time. Review how to stabilize and optimize first!

Why your EMR or PMS Isn’t Enough for Underpayment Recovery
Find out how you can shift the burden of contract management to automated technology and start bringing in missed underpayment revenue.

Practice Acquisition: Due Diligence Checklist for MSOs
Use this checklist to conduct due diligence into your physician group target’s operations, goals, finances, and legal obligations. Ensure it's a fit.

How MSOs Optimize Provider Group Performance After New Acquisition
Get each new practice or physician group carefully tucked in to your MSO or PE organization before you go hunting new targets. See how here.

Revenue Cycle Management Challenges: How Healthcare Providers Can Tackle the Top 6
Review how other healthcare organizations are addressing the top 6 healthcare RCM challenges in our latest blog post.
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Best Practices for Contract Management: 9 Tips for Healthcare RCM Executives
Stop payers from siphoning off your healthcare organization's revenue. Use these best practices for contract management to make sure they pay full contracted rates.

Patient Financial Responsibility: How to Determine It & Convey It for Better Provider Revenue
Patient financial responsibility has risen dramatically in the past five years. Read why providing patient payment estimates early and often is the patient-centric solution.

Medical Appeal Letters: How to Select the Strongest Claims to Appeal and Overturn
The burden is on providers to fight payer underpayments and denials. Explore how you can select the right appeals and words to recover the revenue you've earned!

Healthcare Contract Management: Best Practices
Know which of your payers reimburse at the highest rates, stick to payment deadlines, and respond most quickly. Healthcare contract management makes it work.

Denial Prevention: Workflow Tweaks that Increase Clean Claims
Read how the time invested in denial prevention now returns to you many times over. Use these tips to avoid denials.

Healthcare Contract Management Software: Unlock Revenue & Lift Staff Burden with Automation
Contract management software gets you the access to just which of your payers are missing contracted rates, underpaying you.

Revenue Cycle Audit: How to Prepare For & Crush It
Revenue cycle audit coming up? Know the healthcare industry benchmarks for every step. Prepare to showcase your accomplishments and defend your decisions with these tips.
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Underpayment Recovery for Medical Practices: A Step-by-Step Guide
Explore how medical practices can address and recover payer underpayments. Use these 4 steps to sweep in net revenue and get control over payer contracts.

Revenue Cycle Management Technology: Promises & Pitfalls to Consider Before Investing
Explore RCM technology's effectiveness, current state of adoption within the healthcare industry, and its potential beyond the 2023 CAQH Index's scope..

Healthcare Workflows: Sweep in More Revenue with These 13 Steps
High denials, bad debt, and low clean claim rates indicate your RCM workflows are broken. Explore the 12 steps to repairing healthcare workflows here.

Self-Service Patient Payments: How to Use Them to Improve Patient Satisfaction & Revenue
Explore how you can empower patients to select payment plans and methods for your medical services conveniently from the comfort of home.
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Provider Credentialing: Steps to Limit Payer Denials & Improve Net Revenue
Faulty provider credentialing prompts payer denials, dropping net revenue. Get the steps and strategies to use proper provider credentialing to enhance revenue.

RCM for MSOs: Driving Value Creation with Revenue Cycle Optimization
Healthcare MSOs no longer look first to inorganic growth in their strategic playbook. Prioritizing operational efficiencies is today’s path to value creation.
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Prior Authorization Software: Key Benefits & Elements Your Organization Needs
Learn how replacing manual prior authorization processes with software enhances patient care, streamlines healthcare processes, and alleviates staff workloads.

MD Clarity Celebrates Recognition as a Built In Best Place to Work
We’re proud to be recognized as a Built In Best Place to Work in Seattle, which is a significant achievement that speaks volumes about a company's commitment to its employees.

Change Management in Healthcare: Examples, Models, & Pitfalls
Explore effective change management in healthcare. Learn from real examples, understand its importance, and discover successful models.

Upfront Collections: How to Get Physicians & Staff Onboard with Collecting Pre-Service
Explore the necessity and methods of upfront collections in healthcare, addressing barriers and offering solutions for organizations that want to remain compassionate.

Net Revenue Forecasting: A Guide for Healthcare Organizations
Discover how precise net revenue forecasting can significantly enhance healthcare operations and financial stability, including the latest trends and best practices.

End-to-End RCM: Why Point Solutions Are Better
With healthcare data increasing 47% every year, physician groups and systems must use either an end-to-end RCM or a stack of point solutions. Read why point solutions are better.

AI in RCM: How Generative & Traditional AI Improve Revenue Cycle Management
While you may be using traditional AI in your revenue cycle management processes now, generative is just beginning to surface in healthcare. Both cut costs significantly.

Robotic Process Automation’s Role in Revenue Cycle Management: A Guide
Explore robotic process automation’s potential to improve your healthcare organization’s efficiency, quality and compliance, patient outcomes, and revenue cycle.

Patient Payment Solutions: Leveraging Technology to Boost Net Revenue
More forward-thinking physician groups and management services organizations are turning to automated patient payment solutions to cut costs and increase net revenue..

Payer Contract Negotiation: How to Prepare, Negotiate, & Track Effectively
Providers must advocate for the highest fees and best terms during payer contract negotiation. Use this guide to gather the data and strategy you need to win.