Payment Posting may not be a on leadership’s radar for an area of concern/improvement, but it can routinely be a source of trouble. Inappropriate adjustments and denials can stack up by the thousands in a matter of days, and usually requires lengthy [...]

Over the past several years leading healthcare organizations have been implementing command centers to manage capacity, improve operational efficiency, and reduce unnecessary length of stay.

Earlier this year, we outlined strategy for successfully identifying and introducing revenue guardian checks to your organization’s revenue integrity processes. However, what happens after you implement these checks and what should you be doing for [...]

Our blog post this week focuses on the recent executive order on pricing transparency. Two of our experts, Andrew Wade and Matt Perron, ask each other a few questions on what this could mean for healthcare organizations and what they could be doing to [...]

Revenue Cycle and Finance departments put a great deal of effort and focus on improving industry standard metrics such as: A/R, CFB, ADR, Denial Rates, etc.  Billions are spent every year on consulting and technology solutions to automate and improve [...]

If you have you have implemented an electronic health record (EHR) or are in the initial phases of adoption, have you considered optimization efforts in your planning? Many organizations struggle to find time for EHR optimization due to competing [...]

With increasing patient out-of-pocket liability, healthcare organizations are moving more collections efforts to pre-registration and point-of-service (POS). Starting these conversations early provides transparency for patients, increased overall [...]

The Wilshire Group wants to wish all the amazing revenue integrity professionals that we have worked with a happy Revenue Integrity Week. The work you have done and continue to do is not going unnoticed and we appreciate your dedication to the [...]

In our March Newsletter, the Wilshire Group introduced Quick HITS – short term, focused projects designed to maximize your ROI. We are happy to announce our first patient access focused project, Registration and Authorization Quality!

Often when organizations are trying to decide what areas need the most help, they emphasize revenue gain opportunities first (i.e. missing charges, denials, etc). This usually means revenue acceleration opportunities like insurance follow-up (outstanding [...]