InTegrum Insights

InTegrum Insights is a collection of informative content from the world of healthcare to promote information and knowledge sharing with our clients and resource partners to increase the collective domain expertise.

7 Main Failures Leading to Payment and Resolution Delays

UTILIZATION This category accounts for 25% of all denied charges and includes the clinical areas of medical necessity, pre-authorization, DRG downgrades and experimental treatments. Insurance companies will often challenge whether a specific treatment was medically required, whether the level of care provided corresponded to the underlying morbidity, or whether the length of stay was justified.…

9 lies IT managers tell themselves

You’ve got it all covered: security, budget, stakeholders’ needs. Or do you? These common self-deceptions can come back to haunt your IT initiatives — and your career.   By Christina Wood CIO | JUN 4, 2020 3:00 AM PDT   Some lies are necessary. Like that smile you fake when agreeing to a budget cut. But there are…

7 Ways to Improve RCM

New challenges are brewing in today’s complex and ever-changing reimbursement environment. There are regulatory transitions associated with going from volume- to value-based care, increased patient payment responsibility due to high-deductible health plans, and the need to reduce operating costs. These challenges are just a few of the reasons why hospital CEOs identified financial challenges as…

Seasonal Changes to Hospital RCMs

Winter, spring, summer, and fall bring more than changes in weather, according to a recent analysis of over 1,000 hospitals. Seasonality also has a significant impact on hospital revenue cycle performance, with finance teams reporting fluctuations in net revenue and revenue cycle performance based on the time of year, consulting firm Crowe found. Using data from the…

RCM growth predicted by 68% of Hospital Executives

The annual Healthcare Financial Management Association (HFMA) and Navigant survey of 107 hospital and health system CFOs and revenue cycle management executives showed that 68 percent of organizations plan to increase revenue cycle IT budgets in 2018. Compared to the last year, the survey also showed that 39 percent fewer executives predict a revenue cycle…

WHEN ZERO HAS THE GREATEST VALUE!!!

WHEN ZERO HAS THE GREATEST VALUE!!! PHASE ZERO Workday implementations can transform a company. To ensure a successful delivery every project should start at PHASE ZERO. What is Phase Zero? It is a flexible set of activities, decisions and accelerators to ensure you are ready to start an implementation. Have you prepared for these key…

Hospital Leadership Behind on Discussing Charge Capture

Over three-quarters (78 percent) of revenue cycle leaders at acute care organizations agreed charge capture is essential to an organization’s success, yet most leadership teams only discuss charge capture once a month or less. Those were the findings from a new survey conducted by Sage Growth Partners for analytics company Ingenious Med. Researchers surveyed 104 leaders in…

Major Issues Facing EHR Implementations

The implementation of electronic health record (EHR) is not a new thing in the industry. The digital wave has completely transformed the way medical records were maintaining before and now. With increased demand for efficiency and faster solutions, more and more medical practices are embracing EHR to simplify and organize their data storage process. Initially,…

Epic Modules Supporting Care across Healthcare Settings

Epic Modules Supporting Care across Healthcare Settings The EHR company provides an array of Epic modules specifically designed for providers across the care continuum beyond its industry-leading Epic EHR technology. By Kate Monica Epic Systems offers one of the top-ranked EHR systems in the country as well as a range of products and services to help providers in various…

Importance of Chargemaster Upkeep

ENSURING HOSPITAL CHARGEMASTER MAINTENANCE Hospital chargemaster maintenance is the primary responsibility of the designated team or coordinator. Maintenance is a continuous process that ensures all services are accurately charged, the hospital is compliant with government regulations for pricing, and the organization receives accurate reimbursement. Hospital chargemaster maintenance can be especially challenging as public and private…

Examining the benefits of healthcare analytics

The global healthcare/medical analytics market is expected to reach USD 53.65 billion by 2025, according to a new report by Grand View Research, Inc. Increasing need to reduce healthcare expenditure among hospitals, and other healthcare providers is anticipated to boost growth in the market. The digitalization of healthcare data is also one of the primary…

Increase in ERP Adoption in Healthcare

Enterprise resource planning (ERP) adoption remains slow and steady, HIMSS Analytics recently reported. Hospital ERP adoption increased from 18.8 percent of hospitals in 2008 to 38.4 percent of hospitals a decade later, the analysis of data from the HIMSS Analytics Logic Platform showed. The platform tracks the adoption of over 200 health IT tools. Adoption of…

The Benefits Of Workday

The Benefits Of Workday Change is always a little scary, but the good news is that Workday will make your day-to-day HR and Payroll operations easier! Workday will significantly improve HR and Payroll compliance, reduce risk, provide better data for decision making, and increase efficiencies across the institution. It will also enable people across the…

The ins and outs of healthcare enterprise applications

ERP is helping the healthcare industry to manage its finances better. This software solution keeps track of patients’ payments and costs of supplies and services. Managers can reduce costs that are incurred due to administrative and inventory mistakes, because ERP can monitor inventory levels and finances accurately. In addition, this savvy software can manage purchasing…

The role of the HR system administrator on an HR team

The HR system administrator plays a unique role in a company, providing support for projects and technology initiatives. They can also create a positive experience for new employees. The HR system administrator has a unique role on an HR team. Unlike most HR roles that focus on supporting employees, managers and the business, the HR…

Change management strategies for HRMS implementation

Before you roll out a new HRMS, be sure to communicate the changes to employees and provide them with multiple resources to help them learn how to use the new system. Change management is often critical to the success of a project, and an HRMS implementation is no different. Where do you start? There are…

THE WORKDAY IMPLEMENTATION CHALLENGE MOST LEADERS OVERLOOK

Gearing up for our upcoming Workday implementation has been an adventure, to say the least. I’m amazed when I look back and reflect on all of the things, I’ve learned so far. But when people ask me about the most important challenge for HR leaders to address during a Workday implementation, I always go back…

Hospital Chargemaster Explained

WHAT IS A HOSPITAL CHARGEMASTER? Hospitals, and to a lesser extent physician practices, use the chargemaster to create a summary of charges and services. Hospital leaders also use chargemaster data to track service volume, costs, and revenue. For each service, the chargemaster includes the following components: Item number that is assigned by the facility and unique…

Problems & Solutions of Major EHR Implementations

The vast majority of healthcare organizations have electronic health records systems in place, but the use of such systems does not remain static. New capabilities are added, or organizations decide to rip old ones out and replace them with new ones. For most providers, clinical system implementation is a concern that comes up regularly, and…

Understanding the New CMS Guidelines

CMS Guideline Change Synopsis These changes ONLY impact Medicare and Medicaid Evaluation and Management (E/M) billers/coders (any coder who works for a private practice, outpatient, or general practice that accepts Medicare/Medicaid) right now. Other insurers have not made any alterations. What? Under current CMS guidelines, there are 5 levels of procedures, 1 being a general…

1/4 of US hospitals Lacking Effective RCM Support

More than one-quarter of US hospitals do not have an effective RCM solution in place, according to a recent survey by Black Book Research. Of the hospitals that don’t have an effective RCM product in place, 82 percent said they anticipate making value-based reimbursement decision next year without an advanced software implementation or outsourced partner. If required, 85…

Remote Workforce Management: How to Adapt and Succeed

The increased shift to remote work that we thought would happen over time has instead happened almost overnight. As companies grapple with the resulting challenges, we share ideas for navigating this new territory. Like many companies all over the United States and around the world, Workday has recently made an abrupt shift to remote work.…

Digging deeper into healthcare cybersecurity

Hospitals and healthcare providers remain under cyber-attack, causing organizations to spend more to protect their systems and patient data. Healthcare has been at or near the top of the list for industries at greatest risk of cyber intrusions over the past two years. Many experts predict global healthcare cybersecurity spending will exceed $65 billion cumulatively…

A glance at healthcare RCM

Healthcare revenue cycle management is the financial process that facilities use to manage the administrative and clinical function associated with claims processing, payment, and revenue generation. The process encompasses the identification, management, and collection of patient service revenue. Healthcare revenue cycle management is the strategy that healthcare organizations use to pay the bills. Revenue Cycle…

What is digital transformation? A necessary disruption

What is digital transformation? A necessary disruption Digital transformation is a foundational change in how an organization delivers value to its customers. Here is what transformation truly entails, along with tips to ensure your company is on the correct course. CIOs have come to disdain digital transformation as a concept because it’s meaning has been…

Top RCM Risks of 2019: Medical Billing & Patient Access

Patient access and medical billing and collections are among the top healthcare revenue cycle risk areas for hospitals, practices, and other provider organizations in 2019, according to a new report from the public accounting, consulting, and technology firm Crowe. “Lack of preparation for new risks can cost a healthcare organization money and its reputation at a time…

Outsourcing RCM May Be More Trouble Than It’s Worth

Revenue cycle outsourcing may not be the financial answer hospitals are looking for, according to a recent analysis from the public accounting, consulting, and technology firm Crowe. The analysis of data from more than 1,000 hospitals across 45 states showed that hospitals outsourcing their entire revenue cycle reported higher claim denial rates and longer patient collection times…