SmithRx’s Post

In healthcare, the highest gross margins are in the Medicare Advantage space, according to a recent KFF analysis. Read the full article at https://lnkd.in/gpQauSdX #medicareadvantage #kff #healthcare #medicalcoding #medicalbilling #revenuecyclemanagement #qualcodeinc

According to Chartis, a comprehensive healthcare advisory firm, 50% of the nation’s rural hospitals are operating at a loss. There can be multiple reasons for loss, but unoptimized RCM can be one of the major ones. Hospitals need to collect reimbursement from payers and patients to stay successful. It is also essential to detect revenue leakages. PCH Health has a team of 1000+ RCM experts to provide end-to-end RCM services to hospitals. Click here to learn more about PCH Health and our RCM services. https://pchhealth.global/ #RCM #healthcarercm #denialmanagement #claimmanagement #medicalcoding #rcmexperts #revenuecyclemanagement #healthcare #providers #payers

Navigating the maze of healthcare costs can be daunting, especially when faced with unjustifiably high medical bills 💰 Revolution Health's HI Performance Network offers a groundbreaking approach by providing access to a network of providers that charge at or near Medicare rates, ensuring affordability and transparency in healthcare costs. Join us in revolutionizing healthcare and making fair pricing the standard! https://bit.ly/3zBqUJ0 #HealthInsurance #Insurtech #Healthcare #RevolutionHealthMarketplace #RevHealthMarketplace #RevHealth

🔍 Struggling with 👉 https://bit.ly/4eGer6L credentialing challenges? From delays to compliance, learn tech-driven solutions and best practices for smoother processes in healthcare. Explore real case studies and prepare for the future! #Healthcare #Credentialing #CredentialingChallenges #HealthcareProviders #HealthcareTechnology #ComplianceAudit #HealthcareManagement #MedicalCredentialing #PracticeManagement #HealthcareCompliance #RCM #HealthcareCredentialing

See how we’re enabling healthcare providers to balance increased demand and personalization with efficiency and reliability. #WeCare #NextLevelHealthcare #SupplyChainOrchestration https://okt.to/EP03Jy

How Should Health Systems Deal with Requests from Health Plans to Lower Their Rates? Managed care contracting is an art and science requiring adopting rational 'rules of engagement' and discipline for contracting with health plans. Three general rules to consider are: 1. Health system rates should be based on funds needed for a well-managed, efficient, clinician and patient-focused system to provide optimal access, quality, and service. (see bankruptcy of Vlasic Pickles for what happens when a company lowers price in exchange for volume without consideration of cost) 2. Have ONE BASE RATE that applies to all plans regardless of type, i.e., PPO, HMO, and Exchange plans. This rate can be adjusted incrementally based on the number of denials—higher denials-higher rates, steerage, and expected revenue and service inclusion e.g., specialty pharmacy. 3. If you are an independent, efficient, well-managed health system that cannot negotiate fair rates and terms with a health plan due to the health plan's relative market power, unfortunately, it may be time to consolidate with a partner that can. So it goes n8 #hospitals #healthsystems #healthinsurance

Speed up efficiencies and reduce turnaround times with KarmaCheck. PRN Healthcare experienced these real results after partnering with KarmaCheck. Learn how your team can experience 85% faster credentialing: https://lnkd.in/gs9qcRmQ #Credentialing #Efficiency #Healthcare #BackgroundChecks

Stay ahead of the game in healthcare! With financial struggles impacting practices across the country, strong managed care contracts are more crucial than ever. Don't settle for low rates - True North Physician Agency is here to help you negotiate fair increases with payers. Let's work together to secure the future of healthcare! #healthcare #managedcare #payercontracts #truenorthphysicianagency

PYA's latest white paper includes information providers need for reimbursement related to providing and billing Medicare for remote patient monitoring. Thanks to Martie Ross Ross and Lori Foley, CMA, CHC, PHR, SHRM-CP for their work on this. #healthcare #billing Read the report here: https://ow.ly/NZHa50Qy3mY

Strong payer-provider relationships are essential for better patient outcomes and operational efficiency. Recent insights highlight the benefits of collaboration. Let's focus on building stronger partnerships in healthcare!