Category: Revenue Cycle Management

Hiding Data_ Hospitals Fail to Comply with Price Transparency Requirements

Hiding Data: Hospitals Fail to Comply with Price Transparency Requirements

At first glance, it appeared that hospitals were complying with the Centers for Medicare & Medicaid Services’ (CMS) price transparency requirement, which became effective January 1, 2021. Upon a closer look; however, multiple deficiencies were found. CMS previously advised that it would begin auditing compliance with the rule this past January. Interestingly, it was the […]
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Top 5 Trends Impacting Healthcare Revenue Cycle Management

Top 5 Trends Impacting Healthcare Revenue Cycle Management

The world is changing and the operations behind healthcare reimbursement is changing with it. Healthcare organizations are recovering from an unprecedented public health crisis during which entire service lines shut down so providers could focus on stopping the spread of a deadly virus. Meanwhile, healthcare has been going through a digital revolution. The clinical shift […]
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Biden Administration Shares Latest Round of HHS Staff Appointments

Biden Administration Shares Latest Round of HHS Staff Appointments

Today the Biden Administration announced its latest group of appointments to the Department of Health and Human Services. The new appointees join tens of thousands of career officials throughout the agency at a time when expertise is critical to tackling the ongoing COVID-19 pandemic. WHAT’S THE IMPACT? Kristina Schake will serve as HHS Secretary Xavier Becerra’s […]
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Denials Management Versus Denials Avoidance_ CDI Can Capitalize

Denials Management Versus Denials Avoidance: CDI Can Capitalize

  Typical CDI programs are intended to drive reimbursement through diagnosis securement, contributing to improved case mix index. The COVID-19 pandemic is placing monumental financial stressors upon hospitals, with added costs to treat patients with high acuity and long length of stays, coupled with significant revenue loss associated with postponement of more profitable elective surgeries, […]
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The Importance of Data Security in Medical Facilities

  Today, data breaches, ransomware attacks, and identity theft are endangering privacy and well-being. This is true for medical data because if malicious hackers get access to it, human lives and health could be at stake. Scammers may also attempt to benefit from ongoing events to disrupt the data gathering process for healthcare corporations. Medical […]
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CMS to Reprocess Some Outpatient Claims After Site-Neutral Ruling

CMS to Reprocess Some Outpatient Claims After Site-Neutral Ruling

CMS has announced that it will reprocess hospital outpatient claims from last year for clinic visit services provided at excepted off-campus provider-based departments. The agency will start reprocessing the claims in July 2021 in order to pay all hospitals the same rate as non-excepted off-campus provider-based departments for clinic visit services paid under the Physician Fee Schedule, […]
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Physician Fee Schedule Updates May Increase Reimbursement, Time with Patients

Some updates to the evaluation/management codes on the 2021 Physician Fee Schedule will provide greater reimbursement to physicians and allow them to spend more time with patients, CMS and medical societies said. According to CMS, the code sets that it is finalizing will increase the value of certain services. These include: cognitive impairment assessment and care […]
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