Category: Revenue Cycle Management

Pros, Cons of Non-Emergency Medical Transportation Benefits

Pros, Cons of Non-Emergency Medical Transportation Benefits

MACPAC’s June 2021 report to Congress included findings about non-emergency medical transportation benefits in Medicaid programs that could prove useful for benefits design. A small fraction of the Medicaid population utilizes non-emergency medical transportation (NEMT) benefits, but for that community of beneficiaries NEMT programs can be indispensable, a MACPAC report recently found. It has been […]
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Emergency physicians call United healthcare’s ED denial Policy ‘Dangerous’

Emergency physicians call United healthcare’s ED denial Policy ‘Dangerous’

The American College of Emergency Physicians said that it “firmly believes that the new policy is in direct violation of the federal Prudent Layperson Standard.” Calling it a “dangerous decision” and a “scare tactic,” the American College of Emergency Physicians (ACEP) is condemning UnitedHealthcare’s recent announcement to retroactively deny emergency care claims. “ACEP firmly believes […]
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Physician Compensation Plateaus Despite Pandemic Losses

Physician Compensation Plateaus Despite Pandemic Losses

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, […]
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Advanced Technology Will Help Drive Reimbursement Change (1)

Advanced Technology Will Help Drive Reimbursement Change

  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 […]
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Proactive Strategies for Reducing Mid-Revenue Cycle Leakage

Proactive Strategies for Reducing Mid-Revenue Cycle Leakage

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 […]
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Hospice Addendum Problems Solved

Hospice Addendum Problems Solved

  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 […]
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