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Summary: The Provider's RCM System

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Some key performance indicators a provider's RCM team could use to learn the reasons for the surge in unpaid balances could be the days from discharge to coded, the percentage of denials from the third party payers, percentage of late charges, percentage of returned claims for corrections. Under HIPAA is the transactions rule that identifies eight electronic transactions and 6 code sets. This rule ensures that all providers, third party payers, claims clearinghouses, and so forth use the same set of codes to communicate coded health information. This supports standardization and Administrative simplification. The provider order entry-system that is usually more reliable is electronic. The reason is an electronic order entry system allows

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