Category: Revenue Cycle Management

Quality Payment Program In Clinical Trials

Coronavirus: CMS Urges Use Of Quality Payment Program In Clinical Trials

The Centers for Medicare & Medicaid Services (CMS) is pushing clinicians to participate in the Quality Payment Program to contribute scientific research and evidence to aid in the fight against the COVID-19 coronavirus pandemic. According to a news release, those who participate in COVID-19 clinical trials and report information may now earn credit in the Merit-based […]
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COVID-19 Is Upending the Revenue Cycle

3 Ways COVID-19 Is Upending the Revenue Cycle

The pandemic crisis is disrupting the revenue cycle, including the revenue ramifications of cancelling elective procedures. The global COVID-19 pandemic has sent the entire world into turmoil, including negatively affecting the U.S. economy, causing a ripple effect down to healthcare organization revenue cycles. Many elements of this crisis are already changing the revenue cycle, from […]
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Mastering Revenue Cycle Management

Mastering Revenue Cycle Management

Doctors are fond of complaining that they didn’t go to medical school in order to practice business, but independent physicians do spend much of their time on their practices’ finances. That requires mastering revenue cycle management (RCM), the financial process practices use to administer all the functions associated with claims processing, payment, and revenue generation. […]
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Common Revenue Cycle Issues

3 Twists on Common Revenue Cycle Issues

Denials, automation, and surprise billing are perennially tricky & common revenue cycle issues, but new twists on those topics add an extra layer of complexity. When it comes to revenue cycle management, a handful of common revenue cycle issues are nearly always a struggle, year after year. For instance, denials, automation, and surprise billing are […]
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Impacting the Healthcare Revenue Cycle

How COVID-19 Is Impacting the Healthcare Revenue Cycle

COVID-19 is creating unique healthcare revenue cycle challenges around billing and coding, patient financial responsibility, and resource allocation. As entire nations encourage their populations to stay inside to avoid COVID-19, healthcare providers are more active than ever in response to the outbreak of the novel coronavirus. This activity is having a significant impact on the […]
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New Healthcare Price Transparency Rule

New Healthcare Price Transparency Rule – The Best, Worst, and Most Realistic Case Scenarios

The American Hospital Association has filed a lawsuit to block the rule. On Nov. 15, 2019, the Trump Administration proposed a new healthcare price transparency rule that would basically require hospitals to explain how much a medical service would cost before a patient receives treatment. This rule is due to become effective in January 2021. The […]
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Medicare Advantage and the Medicare Drug Plan

New Directions for Medicare Advantage and the Medicare Drug Plan in 2021

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare Advantage plan (MA, or Part C) and the Medicare prescription drug benefit (Part D) program. In years past, CMS has also issued a “call letter,” not subject to the regulatory process, to provide additional information for plans to use […]
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