Healthcare RCM Archives - Page 5 of 6

October 29, 2021
Blog, Medical Billing
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How 5 Steps For Transforming Patient Access Saved $20M

‘If you can get it right up front, you’re ensuring accuracy, preventing rework, and preventing denials,’ says Alicia Auman, director of patient access at KSB Hospital. Patient access plays a tremendously important role within the revenue cycle, which is why Alicia Auman, director of patient access at KSB Hospital in Dixon, Illinois, has worked […]

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Top 5 Largest Health Insurers in the US by National Market Share

UnitedHealth Group, Anthem, Aetna, and Cigna returned to the list of the top five largest health insurers and one newcomer joined the list. UnitedHealth Group, Anthem, Aetna, and Cigna held onto their status as the top four largest insurers, but in 2020 Kaiser rose to fifth place. AMA was careful to point out that data […]

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Prime Healthcare hospitals cut ties with UnitedHealthcare, citing low reimbursement

Prime’s New Jersey hospitals will continue to honor the rates and services in the agreements until the end of the cooling off period. The decision impacts Saint Clare’s Health in Denville, Dover and Boonton, Saint Michael’s Medical Center in Newark, and Saint Mary’s General Hospital in Passaic. Dr. Sonia Mehta, regional CEO and chief medical […]

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Payer Extends Medicare Advantage Footprint to Reach 5M Seniors

SCAN Health Plan will offer its senior-first Medicare Advantage Plans in 17 markets across three states starting in 2022. SCAN currently provides senior-focused Medicare Advantage plans to 220,000 Californians and aims to reach even more seniors by extending its offerings to Alameda and San Mateo counties. The payer had not offered plans in states other […]

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5 Steps To Revenue Cycle Succession Planning Success

It’s more important than ever for revenue cycle leaders to think seriously about succession planning as baby boomers begin to retire and the revenue cycle increasingly requires more specialized skills, says PeaceHealth’s senior enterprise director of HIM, coding, and CDI. “Everyone’s replaceable,” says Cassi Birnbaum, senior enterprise director of HIM, coding, and CDI at PeaceHealth […]

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Building The Revenue Cycle Of The Future: People, Process, Technology

As the revenue cycle of the future becomes more automated and technology takes over rote tasks, revenue cycle employees need more complicated problem-solving skills and a deeper knowledge base than ever before. Technology is only as good as the data that’s fed into it, and the data is only as good as the people behind […]

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2022 IPPS Final Rule Boosts Hospital Reimbursement

On Aug. 2, 2021, the Centers for Medicare and Medicaid Services (CMS) posted the fiscal year (FY) 2022 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule. Effective Oct. 1, the final rule updates Medicare payment policies and quality reporting programs for inpatient and long-term care hospitals […]

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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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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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Are you a HIPAA entity? The “Privacy Law” May not Be What you Think

The first thing you should know about HIPAA is that it’s HIPAA, not HIPPA, as is commonly seen. There is only one “P,” and that “P” doesn’t stand for “privacy.” If you have heard the acronym “HIPAA” (referring to the Health Insurance Portability and Accountability Act of 1996) thrown around a lot lately, you may […]

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Tag: Healthcare RCM

How 5 Steps For Transforming Patient Access Saved $20M

Top 5 Largest Health Insurers in the US by National Market Share

Prime Healthcare hospitals cut ties with UnitedHealthcare, citing low reimbursement

Payer Extends Medicare Advantage Footprint to Reach 5M Seniors

5 Steps To Revenue Cycle Succession Planning Success

Building The Revenue Cycle Of The Future: People, Process, Technology

2022 IPPS Final Rule Boosts Hospital Reimbursement

Leaked CMS Report Targets Medicare Noncompliance at CA Hospital

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

Are you a HIPAA entity? The “Privacy Law” May not Be What you Think

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