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Dealing with reimbursement difficulties in today's payment environment
Medical Group Management Journal
|April 9, 1991
Summary
Medical groups face reimbursement challenges. Effective strategies involve managing revenue cycles from service initiation through final payment collection, extending beyond the billing office.
Area of Science:
- Healthcare Management
- Medical Economics
Background:
- National medical groups are experiencing significant difficulties with current reimbursement levels.
- This financial strain impacts the operational viability and sustainability of healthcare practices.
Purpose of the Study:
- To identify effective strategies for medical groups to address declining reimbursement rates.
- To explore a holistic approach to revenue cycle management beyond traditional billing.
Main Methods:
- The study analyzes successful approaches implemented by medical groups nationwide.
- It focuses on the entire revenue cycle, from pre-service to post-payment.
Main Results:
- Effective reimbursement management requires a comprehensive strategy.
- Solutions are not confined to the billing department but encompass the entire patient encounter.
Conclusions:
- Medical groups must adopt proactive, end-to-end revenue cycle management.
- Integrating financial considerations before, during, and after service delivery is crucial for financial health.