Streamline Your Revenue LifeCycle Through HIPAA’s Administrative Simplification Regulations

Posted on April 21, 2016

HIPAA administrative simplification regulationsWhen we meet with clients, we often discuss several different audit streams that help us evaluate their revenue cycle and ways to improve it. One area that we’ve found to be of particular frustration for many practices is HIPAA’s Administrative Simplification requirements. Compliance with these requirements is key to an organization’s revenue cycle, and important for its ability to better deliver patient services. Still, many practices feel the process for phasing in these requirements is too costly, and they have a hard time getting past that. This reluctance to see past the expense of compliance reminds us of an important reason why we work with our clients to see the big picture of the revenue cycle as well as the details.

Sometimes it’s very difficult to see the connection between all the rules and regulations that govern our healthcare ecosystem and the bottom line at your organization. Often, it feels like we’re dealing with compliance issues on a different plane than financial or revenue matters, when really they should be in the same conversation. HIPAA’s Administrative Simplification regulations have been phased in over the past five years and will continue under the Affordable Care Act. They live up to their billing — the changes you’ve already implemented at your organization to comply with these rules actually do simplify your life and help your revenue cycle.


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Four Ways to Measure an Electronic Health Record Transition’s Effect on Revenue Cycle

Posted on April 19, 2016

As your practice transitions to using an electronic health record system, track key metrics to ensure your revenue cycle management stays on track.

Gone are the days when the good ship Healthcare Practice floated on a sea of paper. Today, most of us work with electronic health record (EHR) systems to do everything from access patient information to streamline lab testing.

As of 2012, 72 percent of physician offices used EHR systems. That’s up from less than 50 percent in 2009, when the Health Information Technology for Economic and Clinical Health (HITECH) Act was passed, providing incentives from Medicare and Medicaid to organizations that made a commitment to “meaningful use” of technology and adopting EHR systems.1 Since the 2012 data, we’ve certainly noticed even more healthcare entities adopting EHR systems and upgrading from older ones to new systems.

We worked with a Nevada clinic to help it transition from paper records to an EHR, and another practice as it went from one cloud-based EHR system to another that better suited its needs. Since these were already clients of ours, we were in a position to warn them that EHR migrations often result in unplanned revenue cycle disruptions. Outbound claims can stagnate as staff undergo training and learn the new system. Everyone’s emphasis on revenue optimization can falter as multiple departments prepare for migrating from paper to EHR, or from an existing EHR to a new one.


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Prevent a Healthcare Data Breach: Improving Your Patient Health Information Security

Posted on April 14, 2016

i-clipboardIf you’re an executive in the healthcare industry in 2016, you know one of your primary concerns is how to prevent a healthcare data breach. We discuss patient health information security, healthcare IT, new types of hacker attacks, and the latest breaches with our clients on a daily basis. It’s on all of our minds all the time.

Last year alone, the Office of Civil Rights recorded 253 data breaches that put 112 million private health records at risk.1 This is no longer “the IT person’s problem.” Bolstering an organization’s defenses against a data breach should be a cross-departmental initiative driven by leadership.


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Healthcare Data Breaches in 2016: How Your Practice Could Be at Risk

Posted on April 12, 2016

healthcare data breachesWe’ve been hearing a lot of “did you hear?” from our clients lately.

“Did you hear about that Southern California hospital that paid $17,000 to hackers to unfreeze their systems?”1

“Did you hear about ——”

Data breaches and the security of protected health information are on everyone’s mind these days and for good reason. As attacks and breaches rise and intensify, healthcare executives are confronting the need for increased attention and expenditure on healthcare IT.


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What Is a “Good” Revenue Cycle? Evaluating the Health of Your Practice’s Finances

Posted on April 1, 2016

revenue cycleTwo common questions we field from clients are: “So how do we know when we’re done optimizing? When do we know our revenue cycle is good to go?”

These are the billion-dollar questions. Similar to a patient with an ongoing condition asking, “When will I be cured?” the answer is always going to be, “Well, that depends on a lot of factors.” That is where we come in.

Revenue cycle optimization is not a one-size-fits-all prospect. Nor is it a process with a discrete start and end date. Think of it as a living organism, affected by any number of variables that can shift from year-to-year, week-to-week, even hour-to-hour. Revenue cycle management isn’t a “build-it-and-leave-it” task. You must shepherd this complex organism through the life of your organization and keep it as healthy as possible.


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Why Outsource Your Healthcare Executive Search to Your Revenue Cycle Management Partner?

Posted on April 1, 2016

i-penandpaperWhen we first start working with many of our clients, they assume we can only help them with their medical billing and revenue cycle management. Many don’t have any idea that we also offer healthcare executive search assistance, and that we could help them find an executive who can offer new leadership to take the practice to the next level.

We know that successful revenue cycle management starts with having the right executives with the right attitudes working on the right initiatives. When the fit is right, an executive can infuse the entire organization with the sort of leadership that breeds a culture of revenue cycle management responsibility.


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Before Acquiring a Physician Practice, Evaluate These Revenue Cycle Management Factors

Posted on March 15, 2016

We’ve been in the business of assisting clients in managing their practices for a long time, and we can’t remember a time when everything seemed so geared toward mergers and acquisitions. We hear on a weekly basis from one of our clients who is either thinking about merging, being acquired or acquiring a physician practice.

Almost $3.2 billion was spent to acquire physician groups in 2014, and the healthcare trend shows no sign of slowing down. Acquisitions help health systems diversify and stay competitive in certain service areas without needing to build a venture from scratch. Why reinvent the wheel when you can acquire a wheel and keep rolling along, right?1


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Are You Underpaid? Adjust Your Physician Fee Schedule to Unearth New Revenue

Posted on March 11, 2016

Finding new ways to optimize your revenue stream doesn’t have to be an exercise in frustration. Looking at small tweaks to tighten up gaps can be an easy way to give your revenue numbers a boost, and it can be done whether you’re just at the beginning stages of evaluating your revenue lifecycle management or if you have a robust system in place.

Our clients are often astounded at how much loss they could prevent by a few simple checks of their physician fee schedule. We recently worked with a family medicine practice in which a few small tweaks netted several thousand dollars monthly in additional revenue that it had been losing simply by not paying close enough attention to its insurance payers’ explanation of benefits (EOB) documents. Taking a moment on a regular basis to optimize your physician fee schedule can yield previously “hidden” revenue more often than many physician practices realize.


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A Guide to Creating a Revenue Cycle Management Culture and a Gung Ho Team

Posted on March 10, 2016

We were recently leaving a meeting with a client’s billing manager when she said something that made us pause. “I wish the whole team here were as gung ho about revenue cycle management as you guys are,” she said.

The Americanization of the term has come to mean “enthusiastic” or “zealous.” In the original Chinese, gung ho means “work together.” If you think about it, all organizations will benefit from that attitude at all levels, especially healthcare teams in the midst of some major transformations in our industry. Following sweeping regulatory and legislative changes like the Affordable Care Act, we’re seeing huge increases in patient payer responsibility, an emphasis on data, and a seismic shift in the insurance and claims sector.1

Revenue cycle management remains one of the most important areas of focus for healthcare organizations. Creating and nurturing an organization-wide culture of revenue cycle management can foster that gung ho attitude where everyone pulls together toward the common goal of excellent patient care and healthy revenue.


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Filling Out Your Dance Card: Determining Which Revenue Cycle Management Partner Is Right For Your Practice

Posted on February 8, 2016

Revenue LifeCycle Partner
You should be particular when choosing a partner in the dance that is revenue lifecycle management

Just recently, a longtime partner of ours, a diagnostic services center based in the West, reported to us some truly amazing revenue numbers from last year’s third quarter. PRN is so proud to have been a part of their story from the time they were just one small location barely beginning to tweak their revenue cycle factors.

Working with a revenue cycle management partner should be more than just a decision about “outsourcing” or staying “in-house.” With PRN, those kinds of distinctions feel arbitrary — we want you to consider us as dedicated to you as any in-house department responsible for optimizing your revenue. Typically, we start working with our clients when they reach a size where in-house billing, collections, follow-ups, coding, proofing claims, accuracy audits, tracking HIPAA and other laws, and all the big and small things that make up a healthy revenue cycle, has simply become too much.


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