Discover how healthcare providers can accelerate cash flow, minimize denials, reduce operational costs, and enhance patient satisfaction through streamlined Revenue Cycle Management (RCM). RCM is a strategic approach to overseeing all financial aspects of a patient’s journey, from initial appointment scheduling to final bill payment. This article highlights the critical role RCM plays in maximizing […]
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 […]
Ensuring precise claims processing and prompt reimbursements, healthcare practitioners rely heavily on efficient medical billing and coding procedures. The act of streamlining these functions holds the potential to not only heighten overall effectiveness but also to curtail administrative burdens and mitigate the risk of errors. Within this article, we will delve into a selection of […]
As a former emergency department physician from the U.K., this individual was well aware of claim denials and rejections, with payers frequently withholding or reducing payments. However, it was only when his personal insurance company, denied his medical claim for a vitamin D test that he decided to delve deeper into the issue. He found […]
Telemedicine or telehealth, which refers to providing care via electronic communication when patients and providers are in separate locations, has been available for decades. However, the COVID-19 pandemic has accelerated the adoption of telehealth due to the urgent need to deliver care in new ways. Before the pandemic, telehealth faced challenges such as limited reimbursement, […]
Ensure you make a well-informed choice when selecting a company to manage your reimbursements. Physicians seeking to improve their reimbursement rates, financial performance, operational efficiency, or focus on patient care should consider outsourcing their billing needs. However, choosing the right physician billing service for your practice can be a challenging task, as not all services […]
On May 1, UnitedHealthcare made nine changes to its reimbursement policies for its commercial, individual and family, and Medicare Advantage plans. Some of the changes go into effect June 1, while others will begin August 1. Here are nine UnitedHealthcare reimbursement changes happening in the coming months: Commercial plans: Molecular pathology policy, professional and facility: […]
Having been on the receiving end of audits, and also having been an individual who has conducted them, I know the mindset from both sides of this equation. The one element to this equation that has changed over time is the increase in payer denials: those that are now clinical- and coding-focused, often resulting in […]
COVID-19 hospitalization costs varied by state, with the highest in-network cost averaging $128,650. According to a new FAIR Health study, COVID-19 hospitalization cost varies by state, with complex hospitalizations for COVID-19 in-network average cost maxing out at $128,650. “Behind the numbers of our COVID-19 Cost Tracker are the individuals who have contracted COVID-19. As a […]
The number of beneficiaries in traditional Medicare using telehealth exploded 63-fold in 2020 from 840,000 in 2019 to nearly 52.7 million, a new study found. The study, released Friday (PDF) by the Department of Health and Human Services (HHS), comes as advocates are pressing to make key flexibilities the federal government enabled at the start […]










