Faced with long wait times and limited provider access, a multi-state health trust partnered with Conifer to implement a Transitions of Care (TOC) program—empowering members with timely support, care coordination, and personalized guidance.
The COVID-19 pandemic significantly changed how people engage with healthcare, leading to the rise of virtual visits, delayed care, and a greater emphasis on mental health. Now, five years later, it’s essential to understand how healthcare utilization has evolved and what it means for employers.
Clinical Documentation Improvement (CDI) is a strategic initiative to enhance the accuracy and completeness of clinical documentation in patient records. By improving documentation, CDI supports better quality of care and appropriate reimbursement. It also enhances compliance with regulatory standards.
Medical billing isn’t glamorous, but healthcare providers don’t get paid without it, and patient care will suffer. Yet billing errors are everywhere, slowing payments and adding unnecessary stress. The good news? You don’t have to live with them.
Population health focuses on improving healthcare outcomes for groups of people rather than concentrating on individual care. This approach considers the broader health factors affecting communities, including preventive care, chronic disease management, and the social determinants of health.
Understanding what constitutes fraudulent billing prevents healthcare providers from undermining their revenue integrity and exposing their organizations to compliance violations. The greatest financial threat to healthcare providers is medical billing fraud.
Patient access is the foundation for efficient healthcare revenue cycle management (RCM), directly impacting the entire billing and claims process. At its core, eligibility verification affects a hospital’s bottom line.
Unlock the power of smart medical management reporting to drive better health outcomes and streamline your benefits strategy. With timely insights, clear benchmarks, and data that truly informs decisions, you can improve member satisfaction, enhance care coordination, and hold vendors accountable.
Discover how automation is transforming patient access and financial clearance in healthcare. This webinar explores five key automation pathways that improve efficiency, reduce costs, and enhance the patient experience—from eligibility and estimation to authorization and Medicare Advantage identification.
Managing Accounts Receivable (A/R) in healthcare is a complex and ongoing challenge. The nature of payer systems means delays, denials, and inefficiencies that impact patient care.
According to the American Hospital Association (AHA), 78% of healthcare organizations report worsening experiences with commercial payers. Additionally, 84% noted rising costs of complying with insurer policies, and 95% said staff were spending more time on prior authorization processes. That’s why it is important to understand the root cause of these denials to not only quickly resolve them, but also avoid them altogether.
Discover how to optimize revenue cycle performance and drive financial success with this exclusive webinar. Gain expert insights into key revenue cycle challenges, best practices, and innovative solutions designed to enhance operational efficiency and maximize reimbursements.
As healthcare costs continue to rise, employers and benefits managers are increasingly prioritizing strategies to reduce employee inpatient readmissions. Beyond the financial burden, readmissions disrupt productivity, impact workforce morale, and highlight potential gaps in care coordination.
Internally managing revenue cycle management (RCM) presents significant challenges for healthcare providers. Having staff available to navigate the complex world of insurance billing and coding while also having people on hand who will keep up with regulations and compliance isn’t enough.
The importance of accurate medical coding cannot be overstated. Aside from getting proper reimbursement for services, the impact on compliance, data integrity and clinical quality indicators, reinforces that coding in the healthcare ecosystem is non-negotiable.
Employers face rising healthcare costs, and unplanned inpatient readmissions only add to the financial strain. This white paper explores how HR and benefits managers can take a proactive approach to reducing readmissions through comprehensive care management strategies.
The ultimate guide to maximizing profitability by refining the financial and operational backbone of your business. This eBook dives into key strategies for streamlining billing, improving cash flow, and reducing revenue leakage—empowering you to build a more efficient, high-performing revenue cycle.
Transform your healthcare organization’s financial operations with Conifer Health’s expertise and cutting-edge solutions. Our innovative strategies address the challenges of outdated workflows, rising denial rates, and increased patient financial responsibilities.
There are always unknowns about what the year ahead holds for healthcare providers, especially in years when there is a change in presidential leadership and a new administration.
Billing is the lifeline of physician practices, and every dollar lost to inefficiency or error is a dollar that could support patient care. Gaps in billing processes, frequent denials, and staff shortages can derail financial stability, making it harder to keep operations running smoothly.
There are two aspects of the healthcare industry that perpetually challenge providers: the complexity of the healthcare landscape and the dynamic nature of payers.
Streamline prior authorization and enhance patient care with actionable strategies. This on-demand webinar covers ways to reduce administrative burdens, speed up authorizations, and improve payer-provider communication.
Struggling with employee engagement, trust, and health literacy in your sponsored health plans? In our latest webinar, learn about the top challenges faced by employer-sponsored health plans and actionable strategies to overcome them.
This eBook provides a strategic guide for plan sponsors and benefits administrators aiming to enhance the health and productivity of their members, specifically within union or labor groups.
Attention to detail is key in accurate healthcare billing. One of the frequent challenges coders face is handling claim denials, with the CO 6 denial code being a common issue.
Denials due to coding quality concerns are a common challenge in medical billing, often disrupting provider revenue cycles and patient experiences.
For hospitals, health systems and physician practices, delivering excellence in care and providing the best outcomes for patients drive what you do. However, there is a financial side to healthcare, and it’s highly complex.
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