Category: Blog

Medicare Advantage Plans: What You Need to Know

Medicare Advantage Plans: What You Need to Know

Uncertain about the details of Medicare Advantage? Here’s what you need to know. The Medicare open enrollment period, running from Oct. 15 to Dec. 7 annually, is now underway. This gives you the chance to make adjustments to your current Medicare coverage. One potential change worth considering is transitioning from original Medicare (Parts A and […]
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Financial planning for 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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4 Revenue Cycle Startegies that Conquer Denials 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 Authorization: The 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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Top ACA Compliance Mistakes to Avoid in 2024

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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2024 Outpatient Surgery ICD-10 PCS Coding Updates

2024 Outpatient Surgery ICD-10 PCS Coding Updates

As we approach the year 2024, it is important for healthcare professionals to stay up-to-date on the latest coding updates for outpatient surgeries using the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10 PCS). These updates are crucial for accurate and efficient billing, reimbursement, and data analysis. The following is a summary of […]
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Optimizing Healthcare Revenue Cycle: Interoperability Standards and AI Revolution

Optimizing Healthcare Revenue Cycle: Interoperability Standards and AI Revolution

Interoperability standards and AI wield significant influence over the revenue cycle, holding the potential to transform the financial landscape of healthcare establishments. In the constantly evolving realm of healthcare, the infusion of artificial intelligence (AI) has emerged as a game-changing force, promising to revolutionize patient care, diagnoses, and treatments. However, to fully harness the power […]
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