Transparency and Surprise Billing

Jonathan G. Wiik, MHA, MBA, FHFMA
VP Health Insights, FinThrive

Learning Objectives

• Recognize healthcare industry trends and marker forces such as consumerism, medical debt, and uncompensated care
• Analyze CMS provider transparency rules and their impact on provider operations and compliance.
• Contrast the pitfalls and barriers to implementing a new program at your organization to ensure you are successful and supported in your deployment

Overview

Why is it so hard to get paid for healthcare? Challenges from payers, policymakers, providers, and patients have made the U.S. healthcare system one of the most complex in the world. For providers to succeed in this new reality, Revenue Cycle Management (RCM) needs a new vision.

Rethinking Revenue Management is a new approach; it focuses on engagement, collaboration, automation, and strategic approaches to technology – which creates a win/win/win for patients, providers, and payers.

Patients are the new payer and now represent 30-35% of account receivables. Best practices and technology can be leveraged to help hospitals and clinics better address patient financial challenges in today's evolving market. A review of the current CMS regulations surrounding the provider transparency rule will also be discussed. Market trends and best practices for revenue cycle and the healthcare market will also be shared in this session.