Category: Blog

How-to-avoid-financial-burden-from-surprise-medical-bills

Financial planning for Surprise Medical Bills

Costly medical emergencies have the potential to impose a significant financial strain. It’s important to recognize that unexpected and expensive health issues can affect anyone. While we can’t predict when or if we’ll face an unforeseen health challenge, we can take steps to be financially ready. Below are some approaches to kick start your preparations. […]
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2024 CPT code updates for urology

2024 Urology CPT Code Updates: What You Need to Know

The CPT code set for 2024 has recently been released. The modifications discussed below pertain specifically to urology and will become effective on January 1, 2024, across all payers. While pricing and coverage details will be finalized for certain procedure codes, primarily for Medicare, with the release of the Medicare Physician Fee Schedule in late […]
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Importance of Preauthorization in Healthcare RCM

Importance of Preauthorization in Healthcare RCM

Preauthorization is a process in which a healthcare provider obtains approval from the patient’s insurance company before providing certain services or procedures. This process is important for both the patient and the provider, as it helps to ensure that the services are covered by the patient’s insurance plan and that the provider will be reimbursed. […]
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Rev-Cycle-Stories-Strategies-for-denial-management

4 Revenue Cycle Startegies that Conquer Denials Management

Ensuring effective denial management continues to be the foremost concern for revenue cycle leaders, emphasizing the increasing demand for streamlined processes and vigilant oversight. Over the recent months, there has been a notable surge in challenges related to denials management, presenting a multifaceted and costly issue for revenue cycle leaders. Seeking Cost-Effective Solutions? Explore the […]
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Advancing Prior AuthorizationThe Evolution in CMS Regulation

Advancing Prior Authorization: The Evolution in CMS Regulation

The Centers for Medicare & Medicaid Services (CMS) have embarked on a decisive move by enforcing a standard for Advancing prior authorization. In a conversation with the Senior Director of Utilization Management, we discussed the potential implementation and impact of this proposed mandate, slated for enactment in January 2026 The Predicament of Prior Authorization The […]
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ACA-Compliance-Mistakes-to-Avoid-in-2024-and-How-to-Fix-Them

Top ACA Compliance Mistakes to Avoid in 2024

 As the 2024 calendar year’s open enrollment period swiftly approaches, it is imperative for organizations to focus on ensuring compliance with the Affordable Care Act (ACA) in order to guarantee that their procedures for managing health plans are well-executed. Despite nearly a decade of ACA reporting, organizations still tend to make errors in Affordable Care […]
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UHC Commercial Plan Focuses on Price Transparency and Preventive Care

Commercial Plan Prioritizes Affordable Healthcare and Preventive Measures

The emphasis on preventive care by the payer likely contributed to its high re-enrollment rate. Insurance Company’s employer-sponsored healthcare plan, compliant with the Affordable Care Act, has emerged as the fastest-growing commercial plan for the payer. Data from the payer’s Impact Study suggests that the healthcare plan company’s focus on both price transparency and preventive […]
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