Value-based payment is severely lacking as a percentage of total medical revenue across practices as providers face scheduling and billing challenges. The transition to value-based payment is moving at a snail’s pace despite healthcare’s long journey with the transition away from fee-for-service, new survey data indicates. Value-based payment made up just 6.74 percent of total […]
Failing to post files in a machine-readable format was the most common violation of the hospital price transparency rule among NCI-designated cancer centers. Less than one-third of hospitals with National Cancer Institute (NCI) cancer center designation were fully compliant with the CMS hospital price transparency rule, according to research published in JAMA Surgery. The price […]
Self-pay after insurance patient collection rates dropped from 76 percent in 2020 to 55 percent in 2021 as the share of out-of-pocket balances over $7,500 grew. Patient collection rates at hospitals declined and bad debt increased when out-of-pocket bills reached $7,500, according to a report from Crowe Revenue Cycle Analytics (Crowe RCA). The report reflects […]
Another study confirms that medical billing costs in the US significantly exceed those in similar countries, but researchers now know why: coding drives up US administrative spending. Complex coding structures in the US are driving up medical billing costs in the US, making it one of the most expensive countries to get paid, according to […]
While the Moderna COVID-19 vaccine for young children has yet to receive FDA authorization, AMA has created a CPT code to ensure healthcare professionals are prepared for the shot’s potential use. The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include CPT codes for the Moderna COVID-19 vaccine for […]
An organization’s denial rate is a good barometer of its overall financial health and the soundness of its revenue cycle. A recent survey details how organizations stack up. Although most organizations do a good job of tracking denials by reason, payer, and volume, they miss the mark when communicating information about appeals, appeal success […]
Payers, providers, and members can all benefit from transforming the manual and patchwork claims payment process to a digital environment that also automates claims data delivery. Payers, providers, and members are all central to the healthcare experience, working together to create a seamless, coordinated encounter from registration and the clinical visit to claims payment and […]
The Centers for Medicare & Medicaid Services (CMS) has finalized 2022 payments and policies under the Medicare Physician Fee Schedule (MPFS). The rule includes updates to payment rates for physicians and other healthcare professionals for calendar year (CY) 2022; expands the use of telehealth for mental health; clarifies policies related to split (shared) visits, critical […]
More than a third of Representatives call on the federal government to revise No Surprises Act implementation, specifically around the independent dispute resolution process. A bipartisan group of 152 House members wrote to the secretaries of Health and Human Services, Treasury and Labor and urged them to amend the interim final rule (IFR) that will […]
Caitlin Wells Salerno knew that some mammals — like the golden-mantled ground squirrels she studies in the Rocky Mountains — invest an insane amount of resources in their young. That didn’t prepare her for the resources the conservation biologist would owe after the birth of her second son. Wells Salerno went into labor on the […]