Revenue Cycle Latest News

Revenue cycle management encompasses all the administrative and clinical processes that healthcare organizations use to capture, manage, and collect patient service revenue, from documentation and coding to claims submission and payment.

AMN Healthcare Revenue Cycle Solutions shared insights from three health systems in a Michigan Health & Hospital Association webinar, highlighting how addressing mid-revenue cycle challenges such as rising denials and documentation gaps led to meaningful financial and operational improvements.

One of the nation's largest health systems partnered with AMN Healthcare to overcome coding gaps, denials, and compliance risk, resulting in $17.5M in revenue gains through scalable coding and Health Information Management solutions.

Third-party revenue cycle vendors handle sensitive patient and financial data, making them a potential vulnerability in a hospital's overall security posture. AMN Healthcare's cybersecurity resources outline key best practices for vetting vendors and protecting data, operations, and patient trust.

A CDI program helps ensure accurate medical coding and documentation, which reduces payer denials and supports stronger quality scores. An AMN Healthcare case study shows how a healthcare organization in the South improved both its quality scores and revenue by implementing a CDI program in collaboration with AMN Healthcare.

Organizations should shift from reactive to proactive approaches by identifying root causes of denials such as documentation gaps, eligibility errors, and coding inaccuracies. AMN Healthcare's playbook on mastering claims denials and winning appeals offers critical strategies for navigating toward greater financial stability.

The Plan-Do-Study-Act cycle is a Continuous Quality Improvement model that healthcare organizations can use to systematically identify, test, and refine solutions to recurring claims denial problems.