Our white papers cover everything from RAC best practices to in-depth drug reimbursement analysis. See how they can help you improve revenue integrity at your hospital.
A Clean CDM: Three Ways to Overcome Chargemaster Review Roadblocks
Inside this complimentary whitepaper, we examine the three common roadblocks to completing a CDM review and best practices to ensure your next CDM review is successful:
- CDM Clutter and Bad Data
- Lack of Time and Tools to Do the Job Right
- Busy Clinical Department Representatives and CDM Misunderstandings
Building a Better Chargemaster With Supply Data Integration
Inside, the white paper covers the challenges with traditional methods and systems for CDM and supply chain management, the industry trends driving the integration of supply chain and revenue cycle data, and best practices for improving supply revenue capture:
- Establish guiding principles to support the supplies CDM structure you have in place.
- Build an intuitive supply CDM – synching the item master and chargemaster.
- Create a multidisciplinary team to encourage collaboration and communication.
- Monitor and maintain programs to promote accurate pricing.
- Establish key performance indicators (KPIs) and a scorecard for managing charge capture metrics.
RAC Best Practices: Medical Record Preparation & Submission
Please read our “RAC Best Practices: Medical Record Preparation & Submission” white paper. Now more than ever, medical records are in a hybrid state as healthcare entities move towards a true electronic medical record (EMR), presenting a challenge for meeting RAC medical record submission deadlines. The white paper contains valuable information on managing this critical first step when your hospital receives medical record requests from recovery auditors:
- Responding to Recovery Auditor requests in a hybrid EMR and paper medical record environment
- Creating check-off sheets to ensure completedness
- Best practices to avoid incomplete documentation
RAC Best Practices: Utilization Management
Please read our “RAC Best Practices: Utilization Management” white paper. The one area most often targeted by Medicare’s Recovery Audits also happens to be an area that many hospitals overlook. This white paper contains valuable information on preventing and defending against one of the most common causes of Recovery Auditor denials:
- Wrong setting denials
- Medicare’s definition of inpatient
- Noncovered admissions
- Building RAC-proof Admissions screening criteria
Revenue Integrity in Healthcare
Healthcare providers have long relied on conventional revenue cycle management practices to drive and ensure financial performance, yet most are not collecting all the revenue to which they are entitled. This disparity – the gap between the amount of revenue providers are entitled to and the amount of reimbursement eventually received – is called revenue leakage, and it’s a significant problem. The following topics are covered inside this free white paper:
- Making the case for revenue integrity in healthcare
- Common challenges to revenue integrity, such as pricing, internal controls, charge capture, compliance, and denials
- How to create a culture of revenue integrity
- Key strategies recommended for addressing revenue integrity issues
Chargemaster Automation: A Strategic Asset for Achieving Revenue Integrity
From critical access hospitals and independent community hospitals to integrated delivery networks, a growing number of healthcare organizations are choosing automated chargemaster management tools as the best-practice approach to full realization of reimbursement, compliance and efficiency. Based on their outcomes, a promising body of research indicates significant return and benefit for those who have adopted technology to automate chargemaster management processes.
- Market Drivers – Making the Case for Automation
- Challenges of Manual Chargemaster Management
- Achieving Optimal Reimbursement, Efficiency and Compliance
Supply Chain and Revenue Cycle Integration: Asset Management in U.S. Hospital Systems
This white paper is authored by the Health Sector Supply Chain Research Consortium, based at Arizona State University’s W.P. Carey School of Business. Craneware underwrote the research.While the supply chain function has not traditionally been perceived as extending to revenue capture, it is increasingly clear that a linkage between supply chain and those aspects of the hospital that recover money for products used is indispensable for accurate, efficient and consistent cost recovery. The goals of this paper are:
- To formulate an understanding of the current issues facing healthcare providers in supply chain and revenue cycle operations
- To create a progressive practice picture for supply chain and revenue cycle synchronicity that helps to optimize reimbursement and mitigate compliance risk
- To provide a self assessment tool for health care systems to assess their practices in supply chain and revenue cycle management