Ep. 129 Avoiding Costly Mistakes: The Critical Role of Revenue Cycle Management

Описание: Navigating the complexities of healthcare billing can feel like solving a puzzle with missing pieces. So, how do providers ensure they get paid accurately and on time?

In this episode, Sarah Cevallos, a seasoned healthcare leader and expert in revenue cycle management and value-based care, breaks down the complexities of RCM into three key stages: pre-service, mid-cycle, and post-service. She explains how payer negotiations, credentialing, coding, billing, and claim adjudication all play a role in ensuring providers receive accurate and timely payments. Sarah discusses the challenges of outsourcing RCM, emphasizing that high-risk specialties like oncology often require specialized expertise, while simpler services can sometimes be managed in-house. She highlights common pre-registration errors, such as improper insurance verification, and stresses the importance of well-trained front desk staff in preventing claim denials. As healthcare moves toward value-based care, Sarah underscores the need for operational restructuring and patient education to address inefficiencies and meet the growing demand for better, more transparent healthcare solutions.

Tune in as Sarah Cevallos unpacks the hidden challenges of RCM, shares insider tips, and reveals why patient education is key to fixing a broken system!


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