Category: Revenue Cycle Management

Leaked CMS Report Targets Medicare Noncompliance at CA Hospital

Leaked CMS Report Targets Medicare Noncompliance at CA Hospital

A leaked CMS report targeting HCA Healthcare-owned Good Samaritan Hospital in California warns the hospital to fix Medicare noncompliance issues or risk termination. A leaked CMS report put HCA Healthcare-owned Good Samaritan Hospital in California at risk of program termination by October if they fail to fix Medicare noncompliance issues that resulted in patient harm. […]
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Battling EHR dissatisfaction with 4 personalization techniques

Battling EHR dissatisfaction with 4 personalization techniques

  Personalizing your EHR is a proven best practice for new implementations and major system upgrades. These four new approaches boost physician satisfaction and improve EHR usability. When EHRs first emerged 20 years ago, system vendors pushed for standardization. Consistency was considered the only pragmatic way to support end users and enterprise-wide systems. EHR customization […]
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CMS Prior Authorization—operational And Financial Impact

CMS Prior Authorization—operational And Financial Impact

CMS has expanded the prior authorization requirement to two new service categories within hospital outpatient department services. The Centers for Medicare & Medicaid Services (CMS) has expanded the prior authorization requirement for two additional hospital outpatient department (OPD) services. Effective with date of service July 1, 2021, CMS has expanded the prior authorization requirement to […]
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Follow these 5 steps to Ensure HIPAA-compliance when texting patients

Follow these 5 steps to Ensure HIPAA-compliance when texting patients

As long as providers remain HIPAA-compliant, they will be able to text patients with ease and see all the benefits that it brings — including stronger patient loyalty, more revenue, and more referrals. Many people, and that includes patients, prefer to text because it’s quick, easy, and convenient. Texting is incredibly effective for medical practices […]
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UnitedHealthcare loses Medicare Advantage overpayment suit

UnitedHealthcare loses Medicare Advantage overpayment suit

Dive Brief: A federal appeals court has ruled against UnitedHealthcare, the biggest private payer in the U.S., and reversed a 2018 decision overturning Medicare’s overpayment rule requiring insurers to refund reimbursement to CMS within 60 days if they learn a diagnosis lacks medical record support. UnitedHealthcare argued in court in November the overpayment rule was […]
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Dos And Don’ts For Managing Inpatient-to-observation Status Downgrades

Dos And Don’ts For Managing Inpatient-to-observation Status Downgrades

  In the newest episode of the HealthLeaders Revenue Cycle Podcast, Charlie Brown, MBA, a former hospital executive and vice president of revenue cycle at a consulting firm, provides actionable steps for mitigating status downgrades and dealing with them effectively to ensure that organizations receive the full reimbursement for the services they provided. In his […]
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How Policy, Regulation Will Challenge Consolidation in Healthcare

How Policy, Regulation Will Challenge Consolidation in Healthcare

  A new executive order is putting consolidation in healthcare in the spotlight; industry experts share what policy and regulation will mean for provider merger and acquisition activity. Healthcare mergers and acquisitions have promised to bring lower costs, higher quality, and better access to care. But a new executive order is challenging the rapid pace […]
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Healthcare Leaders Identify top digital transformation priorities for healthcare

Healthcare Leaders Identify top digital transformation priorities for healthcare

  A new Lumeon survey lists improving patient access, team coordination, and improving care quality as top wishes, but inadequate budgets, data silos, and inflexible EHRs remain as barriers. While the COVID-19 pandemic highlighted how huge a role technology can play in making the care process more efficient and convenient, simply revving up patient engagement […]
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