Category: Revenue Cycle Management

2024 Medicare Physician Fee Schedule: Changes, Impact, and Updates

2024 Medicare Physician Fee Schedule: Changes, Impact, and Updates

The 2024 Medicare Physician Fee Schedule, recently released by CMS, confirms the anticipated reduction in payments for physicians. The finalized conversion factor of $32.7442 represents a 3.4% decrease from the 2023 rates, which themselves saw a 2% reduction from 2022. In contrast, the Medicare Economic Index, a gauge of practice cost inflation, surged to 4.6%, […]
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Four Common Forms of Virtual Care Reimbursed in Half of US States

Four Common Forms of Virtual Care Reimbursed in Half of US States

According to a recent report, 25 states now provide reimbursement for video, store-and-forward, and audio-only telehealth, as well as remote patient monitoring through Medicaid. Although every state and Washington, D.C. include some form of live video-based telehealth in their Medicaid programs, only 25 of them also offer Medicaid reimbursement for live video, store-and-forward telehealth, remote […]
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How does autonomous coding improve revenue cycle?

How does autonomous coding improve revenue cycle?

A survey revealed that healthcare organizations anticipate that autonomous coding will accelerate the revenue cycle process and enhance coding accuracy. Although autonomous coding has the potential to streamline revenue cycle processes and alleviate administrative burdens, a majority of healthcare finance leaders surveyed either lack familiarity with it or harbor reservations about fully trusting this automated […]
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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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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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The Impact of Location on Claims Reimbursement Speed and Denial Rate

The Impact of Location on Claims Reimbursement Speed and Denial Rate

A recent examination has revealed a significant link between the operational location of healthcare providers and the speed and accuracy of claims reimbursement by insurers. If your practice encounters delays in claims reimbursement, this may be attributed to the geographical area in which your practice is situated, according to a recent scrutiny of financial transactions. […]
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