Average claim denial rates are between 6% and 13%, but some hospitals are nearing a “danger zone” after COVID-19, a survey shows. Hospital claim denial rates are at an all-time high, signaling a need for better claims denial management, a recent survey from Harmony Healthcare reveals. The healthcare industry has seen a 20 percent increase […]
Physicians who institute best practices bring in more revenue and profit than those who do not, and this can be the difference between being successful and being out of business. What’s the difference between a highly successful practice and one that just gets by? Oftentimes, it comes down to focusing on a handful of key […]
Despite a fiscally challenging year for the healthcare industry, physician compensation for most specialties has remained the same or has slightly increased, a new report from the Medical Group Management Association (MGMA) reveals. However, most specialties showed an overall decrease in productivity in 2020. The report utilized data from 185,000 providers spanning over 6,700 organizations, […]
An industry through leader recaps current challenges to traditional reimbursement models for Medical Economics®. Limited by the slow pace of change in traditional reimbursement models, shifts in the paradigm for patient care have also lagged far behind the possibilities created by transformative technology. The COVID-19 pandemic has changed that, catalyzing improvements in reimbursement by […]
Educated guesses and imprecise, stopgap efforts aren’t enough. Revenue cycles need precise strategies to identify exactly where leakage occurs and implement solid processes to stop leakage before it starts. Even before COVID-19, 250-bed hospitals lost $4.7–$11 million a year from mid–revenue cycle leakage. Now, pandemic-fueled volume losses and razor-thin margins mean that hospitals can no […]
2022 Hospice proposed rule would help with addendum statement snags, but other problems remain. In the Hospice proposed rule, published in the April 14 Federal Register, the Centers for Medicare & Medicaid Services outlines these changes to the election statement addendum that was implemented on Oct. 1, 2020. Three vs. Five Days In the […]
ACHP provides several steps that will leverage the advancements of the Affordable Care Act and increase access to high-quality coverage and care. The Alliance of Community Health Plans (ACHP) released recommended steps to build on the success of the Affordable Care Act (ACA) and enhance and expand coverage in the individual health insurance market. First, […]
The Centers for Medicare & Medicaid Services has sent its first wave of warning letters out to hospitals breaking federal rules requiring them to disclose payer-negotiated prices, a spokesperson for the agency confirmed. CMS has been auditing hospitals’ websites and complaint submissions since the rule went into effect on January 1 and began sending out […]
On April 27, 2021, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule for the fiscal year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS). The proposed rule includes CMS proposals for certain annual Medicare payment policies and rates as well as certain quality and value-based programs for FY 2022. Stakeholders must submit […]
Patient access is the first point of contact for patients and the first time staff can get key information right for revenue cycle management success. Patient access is generally the first encounter a patient will have with a healthcare organization, making it central to the patient experience. But this aspect of healthcare is also […]










