PMMC Healthcare Revenue Cycle Blog

Top 3 Trends in Denial Management

Posted by Greg Kay on Nov 21, 2017 3:30:00 PM

During our recent webinar session “Denial Management Essentials: The Metrics and Reporting Tools You Need to increase Revenue” we polled healthcare providers on several topics around denial management.

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How Prevalent are Narrow Networks In Healthcare Today?

Posted by Greg Kay on Sep 28, 2017 8:45:00 AM

During our recent webinar session “Winning Strategies for Contracting in Narrow Networks” we polled healthcare providers on several topics around narrow networks.

These questions provide insight as to how well your organization is prepared to manage narrow network negotiations.

How would your healthcare organization answer these questions?

Here’s how the live webinar attendees responded…

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Almost Half of Healthcare Providers Not Confident in Payer Contract Modeling Tools

Posted by Brad Olin on Sep 20, 2017 12:01:30 PM

At a time where the healthcare industry is forced to adapt to new reimbursement models, providers are having a tough time adjusting to the contract negotiation process. Each reimbursement model comes with its own stipulations and understanding how to work with the payer to reach your organization’s financial goals comes with its own set of challenges.

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The 4 Components of Payer Negotiations

Posted by Greg Kay on Sep 19, 2017 8:45:00 AM

Laying the Foundation

Generally speaking, the key to building and maintaining the success of any complex system is to establish a solid foundation, and the same holds true for healthcare providers modeling their contracts. The foundationmust be stable and flexible enough to allow for future growth as AI and other forms of big data work to cement itself as essential tools in the data analyzation process.

As time progresses and more data gets collected and sorted, however, organizations will be able to utilize this big data to model future contracts with a greater understanding of their primary needs.

Because contract modeling is only one component (a.k.a. “th

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How to Negotiate with Payers – Tips from a Managed Care Expert

Posted by Brad Josephson on Sep 6, 2017 12:07:23 PM

Every profession has its set of experts. In the health industry’s managed care field, one of those experts is Susan Mego.

Susan Mego

Currently serving as the Executive Director - Managed Care for The MetroHealth System and ACO Executive of MetroHealth Care Partners, Susan Mego’s knowledge and extensive experience in the field of healthcare management makes her an invaluable asset to the organization, a clinically integrated delivery system in Northeast Ohio. Susan’s leadership spans over managed care strategies, payer performance, population health initiatives, and contract negotiations with health plans, employers, and providers. Over the course of her career, Susan has enjoyed 20 years in health insurance industry management and 10 years in community/tertiary health system administration as well as serving as teaching faculty at Baldwin Wallace University, each contributing ...

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Revenue, Cost, Productivity and Quality: The Four Modern Day Healthcare Directives Heard in Today’s Boardroom

Posted by Joe Prillmayer on Aug 28, 2017 8:45:00 AM
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Revenue Cycle Consolidation Causes Heartburn For Hospitals

Posted by Palmer Hamilton on Aug 23, 2017 4:31:48 PM

For hospitals contemplating revenue cycle solutions, it’s important to make sure your revenue cycle solutions aren’t half-baked.

Have you ever bought a bunch of ingredients and gadgets to duplicate what the pros make on a cooking show?  They make it look easy…but it’s not.  There are nuanced skills with timing, technique, temperature, and other subtle variables related to sequence and presentation.

Cooking shows are similar to industry consolidation; be it energy, automotive, or even healthcare.

So, what do we get with consolidation? 

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What We Learned (Part 2): 8 Points on Narrow Networking That Every Hospital Needs to be Aware Of

Posted by Greg Kay on Aug 18, 2017 9:44:55 AM

This webinar has taught us a lot about a program in the healthcare industry commonly referred to as narrow networks. We learned about the pros and cons for adopting this type of system, the growing trend of employers offering this to their employees, and most importantly, the value of knowing the contracted terms before entering into these agreements. So, with that being said, what’s the biggest piece of advice we can take away from this presentation?:

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What We Learned (Part 1): How Narrow Networks Impact Healthcare Providers

Posted by Greg Kay on Aug 17, 2017 2:28:31 PM

During our recent webinar session “Intro to Narrow Networks: What’s the Impact on Healthcare Providers?” we polled healthcare providers on several topics around narrow networks.

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Stats on Narrow Networks

Posted by Brad Olin on Aug 15, 2017 8:45:00 AM
Narrow Networks have become increasingly popular among providers looking to provide patients with a comparable quality of care at lower premiums. Here's a look at some stats showing its current success rate:
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