How value-based care affects healthcare billing and payments

By adopting cutting-edge digital patient billing solutions, refining workflows, and prioritizing patient education, organizations can thrive under value-based care models.

Rather than a simple process of paying for each visit or service, value-based billing incorporates shared savings programs, bundled payments, and risk-sharing agreements. For billing teams, these models introduce much more complexity, with payments tied to broader patient care episodes and overall performance metrics.

Efficient patient care and revenue stability begin with benefits verification, even before treatment starts. When verification is timely and accurate, it eliminates billing surprises, reduces claim rejections, and ensures patients have access to care without unnecessary delays. For providers, it means fewer denials, stronger revenue protection, optimized workflows, and a reputation built on trust and transparency. In today’s healthcare landscape, timely verification is no longer optional — it’s essential for patient satisfaction and financial sustainability. Discover why timely verification is critical for both patient experience and financial health: https://lnkd.in/gPS7dzmu #VOB #Verificationofbenefits #Benefitsverification #HealthcareAI #HealthcareFinance #RCM #denialmanagement

Who are the Major Players in the Revenue Cycle? The healthcare revenue cycle is not just about billing and payments — it’s a collaboration between key stakeholders who each play a vital role in ensuring care is delivered and reimbursed properly. 🔑 Major Players in the Revenue Cycle: 🏥 Providers Physicians, hospitals, clinics, labs, and other care facilities Deliver medical services and document diagnoses/procedures Responsible for coding, claim submission, and compliance 🧾 Payers Insurance companies, Medicare, Medicaid, and managed care plans Review claims, adjudicate them, and issue reimbursements Set rules, policies, and contracts that govern payment 👩🦰 Patients Receive care and hold responsibility for co-pays, deductibles, and balances Provide accurate demographic and insurance information Increasingly engaged in understanding their costs and benefits 💡 In short: The revenue cycle is a partnership — providers deliver care, payers reimburse for it, and patients contribute their share. Alignment between all three ensures financial sustainability and quality care delivery. 🌐 www.AtlanticRCM.com | ☎️ (469) 501-1500 #RevenueCycleManagement #MedicalBilling #HealthcareFinance #Providers #Payers #Patients #ClaimSubmission #DenialManagement

🕒 What Is Timely Filing—and Why It Matters in Healthcare Billing? In the world of healthcare revenue cycle management, timely filing isn’t just a deadline—it’s a gatekeeper to reimbursement. Timely filing refers to the specific window of time within which a healthcare provider must submit a claim to a payer (insurance company) after services are rendered. Miss that window, and the claim may be denied—regardless of its accuracy or medical necessity. 🔍 Why Is It Crucial? . Each payer (Medicare, Medicaid, commercial insurers) sets its own filing limits ranging from 30 days to over a year. . Failure to meet these deadlines can result in lost revenue, denied claims, and compliance risks. . Tracking timely filing limits across multiple payers is essential for clean claims and financial sustainability. 📊 Best Practices for Providers & Billing Teams: . Maintain a payer-specific filing calendar. . Automate alerts for approaching deadlines. . Ensure documentation and coding are complete at the time of service. . Conduct regular audits to catch delays before they become denials. 💡 At Atlantic RCM, we help providers stay ahead of the curve—ensuring claims are filed accurately and on time, every time. 🔗 Let’s simplify your billing. 📞 Contact us: www.AtlanticRCM.com | (469) 501-1500 #HealthcareBilling #RevenueCycleManagement #TimelyFiling #MedicalClaims #AtlanticRCM #RCMExperts #CleanClaims #DenialPrevention #MedicalBillingTips #HealthcareFinance

Oracle Health is working to strengthen collaboration between healthcare providers and payers. Learn how this suite of AI-powered applications can accelerate prior authorizations, claims processing, reimbursements, and data-driven care decisions. https://lnkd.in/dN9dWg72

Oracle Health is working to strengthen collaboration between healthcare providers and payers. Learn how this suite of AI-powered applications can accelerate prior authorizations, claims processing, reimbursements, and data-driven care decisions. https://lnkd.in/gSU5CjzM

Oracle Health is working to strengthen collaboration between healthcare providers and payers. Learn how this suite of AI-powered applications can accelerate prior authorizations, claims processing, reimbursements, and data-driven care decisions. https://lnkd.in/gy_FgKb7

Oracle Health is working to strengthen collaboration between healthcare providers and payers. Learn how this suite of AI-powered applications can accelerate prior authorizations, claims processing, reimbursements, and data-driven care decisions. https://lnkd.in/eb6sgWmG

Oracle Health is working to strengthen collaboration between healthcare providers and payers. Learn how this suite of AI-powered applications can accelerate prior authorizations, claims processing, reimbursements, and data-driven care decisions. https://lnkd.in/dCj9xP-z