That sinking feeling when an unexpected, sky-high medical bill lands in your mailbox – it’s a universal experience for many. Welcome to the world of “surprise medical billing,” a frustrating byproduct of our complex healthcare system. Thankfully, new federal protections are in place to shield consumers. But what happens when a surprise bill still sneaks […]
In the complex world of insurance and healthcare claims, the concept of “zero-paid claims” can feel like a phantom menace. You’ve submitted a claim, received an Explanation of Benefits (EOB) or remittance advice, and to your dismay, the payment is… zero. While a zero payment might seem innocuous, it can, in certain scenarios, be interpreted […]
In today’s complex healthcare environment, revenue cycle management hinges on one crucial aspect—denial management. With payers constantly updating policies, and medical claims becoming increasingly complex, denied claims are inevitable. However, they don’t have to be revenue roadblocks. By streamlining the denial management process, healthcare providers can accelerate reimbursements, reduce administrative burden, and significantly boost revenue. […]
2024 medicare part b premium: The Centers for Medicare and Medicaid Services have unveiled the premium rates, deductibles, and coinsurance figures for Medicare Part A and Part B in 2024, along with the income-based monthly adjustments for Medicare Part D in the same year. What is the Impact of 2024 Part B Premiums and Deductibles […]
To ensure both financial stability and operational efficiency, revenue cycle leaders must reinforce three essential areas. The challenges of grappling with low operating margins, diminished reimbursements, and escalating costs will persist throughout 2024. In an era where a subpar financial journey could overshadow a top-tier clinical experience for patients, the burden on revenue cycle leaders […]
Insufficient implementation of revenue cycle management (RCM) strategies may result in disorderliness. Conversely, optimizing RCM in conjunction with billing and collection procedures can mitigate the difficulties, leading to amplified revenue for the practice. The Role of RCM in the Healthcare Sector RCM encompasses both the clinical and business aspects of healthcare institutions, linking patient care […]
For a modern medical practice, efficiency is everything. Labor costs continue to increase, putting a pinch on practices that are still recovering from pandemic shutdowns. An August 2022 snapshot of practices shows that, although physician productivity is increasing, expenses are growing faster than reimbursements. Every person in the practice must work at peak efficiency, from […]
Payment integrity in Medicaid—the concerted effort to keep tight control over fraud, waste and abuse—can be addressed at any stage in the claim cycle. Of course, the earlier it is addressed, the easier it is for health plans to avoid improper payments and the administrative burden of recovering them. And while pre-payment integrity programs maximize […]
To see where and how the use of digital health tools is growing, take a look at the Current Procedural Terminology (CPT®) code set, which opened the door to payment for remote patient physiologic monitoring and is now doing the same for remote therapeutic monitoring and remote therapeutic treatment management. Leading the way in this […]
The Centers for Medicare and Medicaid Services is proposing a decrease in skilled nursing facility payments by 4.6%, or $1.7 billion, in 2023 to achieve budget neutrality. As a result, there will be a decrease of approximately $320 million in Medicare Part A payments to SNFs in 2023, compared to 2022. This estimate reflects a […]