09 Jun Question The regulatory and financial
Question
The regulatory and financial pressures facing healthcare providers, facilities, and payers require timely and accurate medical claim form handling. Payers are demanding an ever-increasing amount of documentation for each claim, and the ICD-10 phase-in along with standards such as the HIPAA 275 will create even greater complexity. This added complexity will further hinder health care delivery services-related cash flow. HIS Applications such as RCM Solutions provide a critical component in optimizing and managing cash flow. There are many vendors marketing RCM Solutions to the health care vertical. RCM solutions for the following three types of business units: a group medical practice, a local community hospital, and a large hospital system
Identify how each of the RCM solutions compares in terms of the variables for the business units and recommend the optimal RCM solution for each. Explain your reasoning.
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