Case Studies and Articles

Article: Revenue Cycle Integrity - Key to Operational Performance

In our industry, buzzwords show up that are just new jargon.  But in this case,  revenue cycle integrity is not just another buzz phrase, but descriptive of how we need to think about and manage revenue cycle.

Hospitals report falling margins for a variety of reasons but one culprit, denials, we can do something about. According to CMS the RACs recouped $2.8 B ...

Case Study - B2B – B2C information technology modernization facilitates long-term capacity and growth

One of the nation’s largest national payers was struggling to meet the burgeoning

transaction load for its batch and real time transactions, especially in the areas of accums

reporting and member liability estimation. As a result, their BCBS scores began to rapidly

decline which could jeopardize their BCBS Association...

Case Study: Consumerism M360, P360 - $20M immediate savings through rationalization of data services

$20M immediate savings through rationalization of data services.  The largest payer in the country, known for innovation and influence on legislation, recognized the early indicators toward Consumerism in the market.  As part of their annual business strategy and technology planning, leadership initiated the evaluation of their current data and analytics...

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