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RCM Insights | Strategies to Maximize Out-of-Network Revenue  with Technology in the No Surprises Act Era

RCM Insights | Strategies to Maximize Out-of-Network Revenue with Technology in the No Surprises Act Era

by Aspirion | Jul 31, 2025 | Payment Variance Recovery, Revenue Cycle Management

Published in HFMA First Illinois Chapter Newsletter, June 2025 | Author: Liana Hamilton, General Manager, Payment Variance Recovery, Aspirion Since the No Surprises Act (NSA) took effect in January 2022, hospital revenue cycle leaders have faced significant challenges...
The Zero-Balance Review Dilemma: Building Internal Teams or Partnering with Experts?

The Zero-Balance Review Dilemma: Building Internal Teams or Partnering with Experts?

by Aspirion | Jun 18, 2025 | Payment Variance Recovery, Revenue Cycle Management, Zero-Balance Review

As healthcare revenue cycle leaders navigate persistent payer resistance, staffing gaps, and mounting operational pressures, two fundamental questions can guide the decision-making process when evaluating a zero-balance review (ZBR) program to retrospectively capture...
Who Is (and Isn’t) a Good Fit for Zero-Balance Reviews

Who Is (and Isn’t) a Good Fit for Zero-Balance Reviews

by Aspirion | May 28, 2025 | Payment Variance Recovery, Revenue Cycle Management, Zero-Balance Review

Healthcare revenue cycle management (RCM) grows increasingly intricate as new legislation, evolving payment models, and sophisticated denial patterns emerge. Revenue cycle executives find themselves navigating an ever-shifting landscape while attempting to pursue...
5 Key Advantages of Zero-Balance Reviews in Healthcare Revenue Cycle Management

5 Key Advantages of Zero-Balance Reviews in Healthcare Revenue Cycle Management

by Aspirion | May 1, 2025 | Payment Variance Recovery, Revenue Cycle Management, Zero-Balance Review

As a revenue cycle leader, you are constantly juggling competing priorities while facing unprecedented financial pressures. Your to-do list never ends—managing denials, addressing contractual underpayments, optimizing your AR days, implementing new payer policies, and...
Recovering Lost Revenue: 10 Causes of Underpayments in Healthcare RCM

Recovering Lost Revenue: 10 Causes of Underpayments in Healthcare RCM

by Aspirion | Apr 10, 2025 | Payment Variance Recovery, Revenue Cycle Management

Healthcare revenue cycle teams are facing unprecedented challenges. Recent findings from the American Hospital Association reveal a troubling trend: half of all hospitals and healthcare systems are struggling with over $100 million in aged accounts receivable claims...
When Payers Second-Guess Doctors: Strategic Steps to Overcome the DRG Downgrade Crisis

When Payers Second-Guess Doctors: Strategic Steps to Overcome the DRG Downgrade Crisis

by Aspirion | Mar 25, 2025 | Denials Management, Payment Variance Recovery, Revenue Cycle Management

Hospitals and healthcare systems nationwide are experiencing an alarming increase in diagnosis-related group (DRG) downgrades. This emerging trend poses significant financial and operational challenges for providers already navigating razor-thin operating margins. But...
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