The Medicare Advantage and Part D rule was implemented on January 1 by CMS. Despite the fact that the Medicare Advantage and Part D rule which came into effect on January 1, 2019 is now in effect, it is quite early to tell whether 2024 will be the year when providers finally overcome the challenges […]
The AMGA says that expanding Medicare Advantage benefits would benefit patients, physicians, and others in the health care industry. For Medicare Part C, also known as Medicare Part C, and Medicare Prescription Drug Benefit Program (Medicare Part D), some policy and technical changes have been approved for 2025 by the association. A public comment period […]
An end-to-end platform is sought by deep adopters of RCM technology from a single vendor, according to a new Healthcare IT research report. Some providers have adopted technology from only one vendor in order to achieve an end-to-end revenue cycle management (RCM) platform. There are several benefits to working with one vendor, but there are […]
As revenue cycle technology has evolved, artificial intelligence has evolved from a buzzword into an established presence. Leaders in the revenue cycle and finance are looking to AI to automate tasks and streamline processes, allowing them to make better use of their staffs as the sector-wide shortage of staff persists. The healthcare media previously spoke […]
Doctors must consider the implications of altering a patient’s status. The Centers for Medicare & Medicaid Services (CMS) is suggesting novel retrospective and prospective appeal procedures in compliance with a federal district court order from the District of Connecticut. On December 21, the agency unveiled a proposed rule aiming to institute an appeal mechanism for […]
Optimizing revenue cycle management is pivotal in rebounding from the profound losses of the previous year. Leading provider organizations have devised three potent strategies. In the aftermath of the COVID-19 pandemic, fine-tuning revenue cycle management takes precedence for financial leaders. Last year, healthcare institutions grappled with substantial declines in both revenue and patient volume, all […]
As we approach the end of 2023 and the holiday season draws near, revenue cycle leaders ought to contemplate including these three challenges in their organization’s roster of New Year’s resolutions. Automating Payer Processes: Similar to healthcare organizations, payers have also started embracing automated solutions, intensifying challenges in managing denials and causing delays in payment […]
Denial rates, notably within Medicare Advantage, are on the rise, impacting both hospital revenue cycles and patient care, remarked the executive director of a Minnesota-based large multispecialty health care organization focused on Revenue Cycle management. Despite the organization reporting a favorable margin this year, it falls short in achieving profits comparable to those of insurers, […]
In the intricate realm of healthcare revenue cycle management (RCM), the substantial challenge revolves around handling denied claims. Scarcity of resources, understaffing, and restricted capacity frequently lead to difficulties in resolving denied claims, where an alarming 82% to 90% are considered potentially preventable. RCM teams can optimize time and revenue recovery by employing proactive strategies […]
Healthcare organizations consistently grapple with the complexity of overseeing their revenue cycles—a comprehensive process spanning patient registration, appointment scheduling, and concluding with balance payments. Yet, a pivotal hurdle disrupting this cycle’s seamless operation is the prevalent occurrence of claim denials. Vital for any healthcare institution’s financial well-being is the imperative to diminish these denials and […]