James Hughes

🏥 Modernize your #healthcare practice with a custom #EHR system. 🩺 Simplify appointment scheduling, reporting and patient engagement—while staying #HIPAA compliant. Learn more: https://casp.io/3Ow3tFh #lowcode

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Even though 75% of our survey respondents were highly familiar with their RCM process, just 31% believe they have an accurate view of their claims and denials process. Learn more in our 2024 market report: https://hubs.li/Q02FBwDt0 #RCM #practicemanagement #healthcareproviders

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The Change Healthcare hack opens the door to the likelihood of unprecedented fraud. Boe Hartman, Nomi Health's co-founder and CTO, outlines five immediate threats that demand attention. These scenarios aren't just theoretical - they're blueprints for impending chaos: https://lnkd.in/gWEGdUiA MedCity News #ChangeHealthcare #DataBreach

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As the use of artificial intelligence in healthcare claims management widens, the importance of careful oversight is needed. Any use of automation for claim denials should be scrutinized by providers to ensure the denial is appropriate. Read more at https://lnkd.in/e_yBqb4t

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On average, healthcare organizations face a 5-10% denial rate for claims submitted to insurance payers. While this might seem small, it translates to significant revenue losses. The good news? 90% of these denials are preventable! By leveraging data analytics, providers can: ✅ Reduce denial write-offs by 42% ✅Improve clean claim rates by 19% Understanding key denial causes can drive efficiency: ✅50% of denials are front-end, primarily due to missing or invalid patient information. ✅30% arise from coding errors. #Healthcare #RevenueCycleManagement #DenialManagement #DataAnalytics

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Automate the entire medical bill cycle via Data Dimensions, no matter the carrier or bill review company, including Specialty and PPO networks. Learn more: http://bit.ly/3Un90ju #ClaimsandBillAutomation #billautomation #claimsautomation #medicalbills #PPO #technology #automation #DataDimensions

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❗ REGISTER FOR THE UPCOMING WEBINAR ❗ Join EBS of RCM&D and Mutual of Omaha for a comprehensive session on the latest developments in Maryland Paid Family and Medical Leave. This is a unique opportunity to gain insights and stay ahead of the curve in understanding how these changes can impact you and your organization. Register here: https://lnkd.in/gjhT2R_m Ben Bohonowicz, Sarah Hipp and Tim Detwiler will cover: ✔ An overview of the Maryland FAMLI program  ✔ Private plan options   ✔ Implementation timelines and employer preparation ✔ FAQs 

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📋 Streamlining your billing department's processes can significantly expedite claim resolutions and reimbursements. 🚀 Keep pre-authorizations accessible! Dive deeper into these insights with Gisele Saenger's book, 'The Business Side of Podiatry Revenue'. 💡 https://bit.ly/3GU7IYo

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Tough RCM Questions with Michael Quinn from Inovalon - Healthcare IT Today #ToughRCMQuestions with Michael Quinn from Inovalon In a recent interview, Michael Quinn from Inovalon addressed several challenging questions related to revenue cycle management (#RCM) in healthcare. Here are the key takeaways from the discussion: #ImportanceofDataIntegration Quinn emphasized the importance of data integration in RCM processes. He highlighted how integrating data from various sources can streamline operations and improve revenue collection. #RoleofPredictiveAnalytics Predictive analytics play a crucial role in optimizing revenue cycle performance. Quinn discussed how leveraging predictive analytics can help healthcare organizations identify trends, forecast revenue, and make informed decisions. #ChallengesinRCM Quinn acknowledged the challenges faced by healthcare organizations in RCM, such as ai.mediformatica.com #health #inovalon #healthcare #michaelquinn #this #about #healthit #healthcareit #healthcareittoday #interview #management #revenue #digitalhealth #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/4dun2rV)

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⚠️ 𝗠𝗲𝗱𝗶𝗰𝗮𝗿𝗲 𝗔𝗱𝘃𝗮𝗻𝘁𝗮𝗴𝗲 (𝗠𝗔) 𝗽𝗹𝗮𝗻𝘀 𝗮𝗿𝗲 𝗳𝗲𝗲𝗹𝗶𝗻𝗴 𝘁𝗵𝗲 𝗳𝗶𝗻𝗮𝗻𝗰𝗶𝗮𝗹 𝘀𝗾𝘂𝗲𝗲𝘇𝗲, 𝗮𝗻𝗱 𝗼𝘂𝘁𝗱𝗮𝘁𝗲𝗱 𝗰𝗼𝘃𝗲𝗿𝗮𝗴𝗲 𝗱𝗮𝘁𝗮 𝗶𝘀𝗻'𝘁 𝗵𝗲𝗹𝗽𝗶𝗻𝗴. When CMS overestimates Other Insurance coverage due to bad data, it means plans are missing out on premium revenues while members are racking up medical costs at commercial rates. Here’s 𝗼𝘂𝗿 𝘀𝗼𝗹𝘂𝘁𝗶𝗼𝗻: By maximizing MSP and COB accuracy with a 𝙜𝙡𝙤𝙗𝙖𝙡 approach to TPL Data, payers can accurately identify when Medicare is truly primary, collect those premiums, and ensure payment accuracy – reducing costs and increasing savings and compliance. Get started today and see how much you could save with AuditShark COB! Source: https://lnkd.in/gwijwjVy    #MedicareAdvantage #MA #ClaimShark #Payers #MSP #CoordinationOfBenefits #COB 

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Discover how Florida's home care agencies can thrive in 2025 and beyond! Patti Heid, Senior Director, Best Practices & Compliance, Home Care Association of Florida emphasizes the need for proactive strategies to navigate upcoming OASIS requirements and the evolving Medicare landscape. By embracing AI technology and fostering strong payer partnerships, agencies can enhance service delivery and operational efficiency. Read more what she has to say here: https://lnkd.in/g27FtN4G

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Register to close care gaps using CDI: https://lnkd.in/gXRqb3Be Healthcare disparities plague the industry, leading to worse health outcomes for specific member groups. Traditional administrative claims data often lacks the clinical granularity needed to expose the full picture. This webinar tackles the power of Clinical Data Integration (CDI) in identifying these hidden disparities. Leverage the expertise of Health Chain as we delve into how CDI programs can analyze clinical data to reveal: 🎯 Disparities in Dx/Px Rates: Unearth discrepancies in diagnosis (Dx) and procedure (Px) rates across different member segments. This unveils potential under-treatment or missed opportunities for early intervention in high-risk populations. 🎯 Preventive Care Gaps: Uncover potential differences in preventive care utilization across different member segments. Racial and ethnic minorities often experience lower rates of preventive screenings compared to white populations. 🎯 Leverage CDI to identify these disparities and develop strategies to close the gap and improve overall population health. 🎯 Social Determinants of Health (SDOH) Impact: Social factors like income, education, and access to healthy food significantly influence health outcomes. 🎯 Leverage CDI to identify SDOH impacting specific communities within your member base. Here from Nikita Ravindran and Vinay S. how Health Chain’s robust CDI solutions can be used to identify these disparities within your member population. Tune in at 1pm CST | 11am PST on 27th September 2024 to learn practical strategies to leverage rich clinical data captured through CDI for developing targeted interventions and improving health equity for all members. Bonus for attendees 📣 Get a free copy of Gartner’s report on “How Clinical Data Integration Improves U.S. Healthcare Payer Interoperability” #CDI #Caregaps #populationanalytics #healthcaredata #FHIR #payers #HCwebinars #Gartner Sudheen (Sudheendra) Kumar Mason Burr

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Are you ready to unlock ERISA’s potential in managing insurance claims and denials? Join today’s Office Hours session, "Unlocking ERISA: Navigating Insurance Claims, Denials, and Recoupments," and learn how to use ERISA guidelines to protect patient claims and enhance revenue integrity. 11am PT / 1pm CT / 2pm ET Don't miss out – there’s still time to register: https://hubs.li/Q02yZVvH0 #ERISA #DenialsManagement #AI #RCMAutomation #MachineLearning

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Selecting the right Medicare agent might seem overwhelming, especially for seniors venturing into the complex world of Medicare for the first time. Understanding what you need is the initial step towards finding an agent capable of offering personalized, expert guidance. Here are key considerations to keep in mind: Expertise and Experience: Look for agents with a solid understanding of all aspects of Medicare. Location: Consider local agents who understand your state's specific Medicare options. Reputation: Seek out agents with positive testimonials and a good reputation. Services Offered: Determine if the agent provides the specific services you need.

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ON-DEMAND WEBINAR: Is your RCM partner up to today’s security challenges? If you’re unsure, it’s time to find out. Watch to uncover how recent cybersecurity events have refocused vendor-selection requirements and what to evaluate during review.  #Cybersecurity #RevenueCycleSecurity #RCMSecurity

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We created an essential guide for RCM teams to take their departments to the next level! 💼✨ Discover 4 powerful steps to boost efficiency, streamline workflows, and achieve next-gen productivity. Here’s what you’ll find: • Three tips to Set Clear Goals and KPIs • Four ways to Structure Your RCM Team for Success • How to Use Automation and AI Intelligently • The number one way to Maintain a High-Performing RCM Team 💪💡 Access the full article and graphics 👉 https://lnkd.in/erJzR8Hx 📈💰 #RCM #Productivity #HealthcareAI #RevenueCycleManagement #Innovation #TeamSuccess #AIIntegration #HealthTech #NextGenRCM

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Connie Health Acquires Keen Insurance Services, Expands Reach - HIT Consultant #ConnieHealthAcquisition #KeenInsuranceServices #HealthcareIT #Expansion Connie Health, a prominent healthcare IT company, has recently acquired Keen Insurance Services to broaden its reach in the industry. This strategic move will allow Connie Health to offer a wider range of services and solutions to its clients, further solidifying its position in the healthcare IT market. The acquisition of Keen Insurance Services will enable Connie Health to enhance its offerings in insurance-related technologies and services, providing a more comprehensive solution for healthcare organizations. This expansion will strengthen Connie Health's presence in the healthcare IT sector and allow it to better serve its customers with innovative and efficient solutions. #HealthcareTechnology #StrategicAcquisition #InnovativeSolutions ai.mediformatica.com #health #medicare #this #insurance #seniors #acquisition #healthcare #market #technology #guidance #informed #network #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/4dxo7yI)

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Get ready to meet CareSpace, the platform you need for proactive risk adjustment! Swing by on the 23rd Risk Adjustment Forum in New Orleans, May 20-22, 2024, and check out how CareSpace pulls together data from all over the place – claims, clinical, HIEs, ADT, SDoH and others – to give you the full picture of patient health. The platform uses AI to generate insights that are pushed to providers at the point of care, shifting risk adjustment from a retrospective, audit-centric function into a proactive workflow that can really influence care. Don't miss the chance to see how CareSpace works its magic! #Persivia #AI #AIinHealthcare #RiskAdjustmentForum

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