Category: Revenue Cycle Management

Advances in AI and Technology for Efficient Value-Based Care 2024

Advances in AI and Technology for Efficient Value-Based Care 2024

Value-based care in 2024: As 2024 approaches, healthcare is undergoing unprecedented innovation and digital transformation. Emerging technologies and capabilities are empowering organizations, including payers, providers, and self-funded employers, to confidently embrace risk within value-based care programs. The American Academy of Family Physicians reports that 49% of practices participate in some form of value-based payment, and […]
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Differences: Preventive vs. Office Visits in Medical Coding & Billing

Differences: Preventive vs. Office Visits in Medical Coding & Billing

Preventive Services Vs Office Visits: It is important to note that Medicare does not cover preventive services in the same manner as commercial payers. Therefore, it is important to know the patient’s policy and insurance coverage. Table A shows a breakdown of the coverage parameters. Understanding the distinction between Preventive Services Vs Office Visits is […]
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Boost Revenue & Reduce Denials: Expert RCM for Healthcare Providers

Boost Revenue & Reduce Denials: Expert RCM for Healthcare Providers

RCM Company has been at the cutting edge of making a difference in healing centers and wellbeing frameworks addressing patient-involved (coordination of benefits) and clinical dissents, recouping on low-balance accounts, and resolving complex claims. Getting these ranges of the income cycle settled rapidly and effectively is becoming tall need these days, as healthcare providers confront […]
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Final Rule for Streamlining Prior Authorization Processes Unveiled

Final Rule for Streamlining Prior Authorization Processes Unveiled

In an effort to streamline prior authorization processes, provider bunches, including the American Medical Association (AMA) and the Medical Group Management Association (MGMA), have asserted that the ultimate goal of the new regulations will assist in facilitating a more efficient and effective prior authorization workflow. Provider bunches are commending CMS for finalizing understanding data-sharing approaches […]
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CMS Unveils Medicaid Payment Model for Improved Behavioral Health

CMS Unveils Medicaid Payment Model for Improved Behavioral Health

CMS’s Medicaid Payment Model show can be seen as a healthcare bridge, giving fundamental behavioral wellbeing administrations to both Medicaid and Medicare beneficiaries over a period of eight years. As portion of a unused Medicaid Payment Model demonstrate reported by CMS, physical, behavioral, and community suppliers will be required to arrange care in arrange to […]
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CMS Unveils Final Rule to Streamline Prior Authorization Processes

CMS Unveils Final Rule to Streamline Prior Authorization Processes

Affected payers have to be sent earlier authorization choices inside 72 hours for pressing demands and seven days for standard requests. Under a last run the show discharged nowadays, affected payers will be required to send earlier authorization choices inside 72 hours for critical demands and seven calendar days for standard requests. The Centers for […]
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Enhancing Medicare Advantage Benefits for Patients and Providers

Enhancing Medicare Advantage Benefits for Patients and Providers

The AMGA says that expanding Medicare Advantage benefits would benefit patients, physicians, and others in the health care industry. For Medicare Part C, also known as Medicare Part C, and Medicare Prescription Drug Benefit Program (Medicare Part D), some policy and technical changes have been approved for 2025 by the association. A public comment period […]
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