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 […]
This has, in turn, put greater emphasis on the need for Revenue Cycle Management (RCM) systems to enable a healthcare provider to better manage transactions between payer, provider and patients. It can, through the use of various software platforms, boost revenues, reduce denials and enhance the patient experience. According to a survey published by […]
Additionally, those who were younger than 75, lived in the west and had internet connectivity were more likely to use video or voice calls to interact with their physicians. Medicare beneficiaries living in metropolitan areas were more likely to report that they used telehealth services, a new study revealed. Published in the Journal of Evaluation […]
CMS attributes the increases in part to rising prices and utilization across the healthcare system, as well as Aduhelm. The standard monthly premium for Medicare Part B enrollees will be $170.10 for 2022, an increase of $21.60 from $148.50 in 2021. This represents a 14.5% increase. The annual deductible for all Medicare Part B beneficiaries […]
The survey found that median provider salary and benefits expense as a percent of net revenue increased from 72.1 percent to 84.9 percent, which is the outcome of provider compensation being protected during the COVID-19 pandemic combined with decreased productivity. In addition, the survey showed a net revenue decrease from 24.2 percent to 22.8 percent […]
The delivery and payment of care will look a lot different by 2030, according to CMS. The federal agency has announced that it expects all Medicare beneficiaries with Parts A and B to be in a care relationship with accountability for quality and total cost of care by the end of the decade. At the […]
To reduce care variation, SSM and Optum will use clinical technologies, advanced analytic and data-driven insights at the point of care. Certain SSM Health revenue cycle staff and hospital care management will become employees of Optum. They will continue to work in their current locations across Illinois, Missouri, Oklahoma and Wisconsin. WHY THIS MATTERS As […]
Kaufman Hall predicts hospital operating margins will fall 80% below pre-pandemic levels by the end of 2021. Projecting cash flow always has been a challenge, but now that hospitals are operating on extremely tight margins, access to accurate projections is critical. On a related note, research from Market cube and Waystar found that fewer than […]
In its simplest form, revenue cycle management is the process healthcare providers use to ask for, track, and collect revenue for services rendered to patients. But as medical billing gets more complex, revenue cycle management is expanding beyond the business office. At Jackson Hospital in Montgomery, Alabama, for example, revenue cycle management also includes health […]
Advanced primary care can help employers control costs and coordinate care, but many employers do not know how to start and scale such a solution in their employer-sponsored health plans, according to a report from the Duke-Margolis Center. Primary care is an essential part of preventing high-cost health conditions among employees. However, only slightly more […]