Highway to Health – Season 1
A show of hands: How many people were adept at taking an in-home health test before the pandemic? The answer: probably not many. The pandemic changed that, along with so many other healthcare processes. Taking a COVID test, a healthcare assessment, or even a virtual patient visit weren’t things most were used to doing at…
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Articles Healthcare
Highway to Health: Referral Management Paired with E-consults Delivering for Patients and Providers
The healthcare industry is facing a lot of challenges, like physician burnout, the high cost of care, a lack of insurance coverage, staffing problems, and a lack of adequate interactions between patients and providers, just to name a few. With the loads of technology and applications available, many providers still use fax machines as a…
Articles Healthcare
Provider & Payer Dynamics: Revenue Cycle’s Evolution
Pre-authorization is a word that is being tossed around more and more frequently in the healthcare world. Often referred to as pre-approvals, prior approvals, or prior authorizations, these are insurance-dictated restrictions on medicines, tests, or health services that require a check before insurance will officially cover the product or service. More than three quarters of…
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Patient’s Responsibility in the Financial Side of Healthcare
Patients’ financial responsibility has been increasing over the years, and this trend is stepping-up healthcare costs, with no assurance it’s going to slow down in the future. According to patientengagementhit, patient financial responsibility increased by 11 percent in 2017, a rise from $1,630 in Q4 2016 to $1,813 in Q4 2017, totaling an increase of…
Articles Healthcare
Unlocking Your Body’s Ability to Fight Cancer
The common saying, “You are what you eat,” may indeed be true. Consuming unhealthy food and beverages can put you at increased risk for developing chronic health conditions, obesity, and even 13 types of cancer, according to the Centers for Disease Control and Prevention (CDC). While this may seem disheartening, new research shows that nutritional…
Articles Healthcare
Referral Management and Health System Revenue Leakage
Staying on top of your health isn’t always easy. Time, money, and knowledge all play a big role in shaping your healthcare. Missing a follow-up appointment might not seem like a big deal, though it could be a game changer for your health or your practice and staying on top of appointments should be a…
Highway to Health
Intelligent Automation: Meeting Patient Expectation
Key Points: The administrative burden on the provider is what translates into poor patient experience. Many big tech companies going into the healthcare business are finding it challenging because they do not have a proper understanding of how it works There is a need for alignment between patient needs and what healthcare providers are offering…
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The Sustainability of the Healthcare System
The sustainability of the healthcare system won’t be secured by another round of cost-cutting or clever benefit design alone, but by a hard cultural pivot toward alignment: payers, providers, employers, and patient advocates pulling on the same rope instead of grading each other on different exams. Right now we’ve built a maze that…
Allow Doctors to Provide Care Without Making Patients Fight the Insurance System
Patients shouldn’t have to become their own case managers just to access a hip replacement, transplant, or any other life-changing procedure; the moment they’re pushed into a paperwork fight, the system has already shifted its burden onto the sick. In a functional healthcare model, clinicians and their teams handle the insurer negotiations behind…
The Impact of Physician Advisors on Hospital Revenue and Patient Advocacy in a Payer-First Era
Physician advisors are becoming the quiet linchpin of hospital resilience in a reimbursement environment where insurers increasingly treat care like a spreadsheet exercise. As payers tighten criteria and automate denials, the gap between clinical reality and business logic widens—and without a skilled physician advisor (and a disciplined appeals pathway), health systems risk watching…
How Hospitals Can Defend Against Payer Denials Without Sacrificing Patient Care
Payer denials used to feel like a series of personal affronts—clinicians and administrators trading war stories in hallways, certain they were being shortchanged but lacking the proof to do more than fume. Today, that fog should be lifting: with data warehouses, smarter analytics, and years of claims history, hospitals can pinpoint which payers…
