Category: Revenue Cycle Management

Build your financial success dream team

Build your financial success dream team

  Many busy physicians find they don’t have the time and energy to develop a savvy financial plan for their practice or their own personal needs. That’s why physicians needs the collaborative support and guidance of a good financial team. Many physicians never learned anything in medical school about running a business or handling personal […]
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AMA: Prior Authorization Creates Physician Burden, Patient Care Delays

AMA: Prior Authorization Creates Physician Burden, Patient Care Delays

Although health plans aim to promote value-based care with prior authorization requirements, providers and patients may experience negative repercussions from the process. Prior authorization negatively impacted patients and providers alike by leading to care delays for patients and creating administrative burden for physicians, according to a survey from the American Medical Association (AMA). Health plans […]
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Hospitals Face Medicare Payment Cuts

Hospitals Face Medicare Payment Cuts

Low-performing hospitals to see a 1 percent cut in Medicare payments under HAC Reduction Program in 2022. The Centers for Medicare & Medicaid Services (CMS) announced last month that 764 hospitals will face Medicare payment cuts in fiscal year (FY) 2022 under the Hospital-Acquired Condition Reduction Program (HACRP). The value-based program may reduce Medicare payments […]
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Survey finds just 14% of hospitals are compliant with price transparency

Survey finds just 14% of hospitals are compliant with price transparency

The biggest noncompliance was non-posting or incomplete posting of all of the negotiated prices for each item and service. In a federal price transparency rule that took effect January 1, 2021, hospitals were tasked with posting all of their prices online in clear, easily accessible formats. But a new survey from patientrightsadvocate.org has found that, […]
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AHIP warns proposed ACA exchange rule could threaten market’s growing stability

AHIP warns proposed ACA exchange rule could threaten market’s growing stability

  AHIP, the top lobbying organization for commercial insurers, is warning the feds that provisions in its proposed rule governing the Affordable Care Act’s exchanges for 2023 could “undermine” the growing stability there. For instance, the group says in comments (PDF) submitted late Thursday that potential changes to requirements for essential health benefits would limit […]
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Rural Health Clinic Policies Revised

Rural Health Clinic Policies Revised

  Don’t send another RHC claim until you’ve reviewed these key changes for 2022. A Rural Health Clinic (RHC) is a clinic located in a rural, underserved area with a shortage of primary care providers, personal health services, or both. Medicare pays RHCs for the provision of certain primary care and preventive health services in […]
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CMS Proposes Changes to Medicare Advantage and Part D Programs

CMS Proposes Changes to Medicare Advantage and Part D Programs

On January 12, the Centers for Medicare & Medicaid Services (CMS) released the Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs proposed rule, representing CMS’ first major policy proposals for these programs in the Biden Administration. The changes proposed are, overall, modest in scope. In the […]
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Electronic Payment Key to Streamlining Healthcare Claims Management

Electronic Payment Key to Streamlining Healthcare Claims Management

The complexity around healthcare claims management is a major pain point for provider organizations, big and small. The increasing cost of claims coupled with a complex system of many payers, each with their own rules and requirements, creates administrative burdens and obstacles for providers. Ultimately, this complex system impacts the patient experience, as patients must […]
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