Tag: No Surprises Act

Impact of Healthcare Reform on RCM

Healthcare Reform Update: How New Regulations Affect RCM

Health care in the United States is constantly changing, with new regulations and policies being developed to improve patient outcomes, increase access to care, and reduce costs. Impact of Healthcare Reform on RCM, keeping up with these changes is essential for Revenue Cycle Management (RCM) professionals. New regulations can impact everything from billing and coding […]
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Healthcare reform

Healthcare Reform: How It’s Affecting Medical Billing

Medical billing is shaped by healthcare reform, which is one of the most dynamic forces at play. Legislation, regulatory changes, and shifts in healthcare delivery models have led to a significant change in how providers bill. In response to the continued push for value-based care, increased patient responsibility, and technological advancements, medical billing is evolving. […]
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Future of medical billing services

The Future of Medical Billing Services: Preparing for the Next Wave of Challenges

Medical billing is experiencing significant changes as the healthcare industry rapidly evolves. Healthcare providers are facing new challenges managing their revenue cycles as the sector becomes more complex. The future of medical billing services is not without obstacles. However, medical billing services play a critical role in ensuring providers receive timely and accurate reimbursement for […]
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NSA Implementation

Congressional Concerns: Lawmakers Challenge CMS on NSA Implementation

NSA Implementation Shortly before Congress adjourns for 2023; lawmakers sent another in a series of letters to the Centers for Medicare and Medicaid Services (CMS) expressing “serious concerns” about the implementation of the No Surprises Act (NSA). The letter accused CMS of failing to properly implement key portions of the law and suggested that the […]
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IDR resolution processing fees have been revamped

Updated IDR Processing Fees Post-No Surprises Act Lawsuit

As a result of the most recent provider lawsuit, IDR processing fees have been reworked. Since its inception on Jan. 1, 2022, the No Surprises Act (NSA) has had its growing pains, including four lawsuits challenging the process of Independent Dispute Resolution (IDR). Out-of-network services are paid for with this process when health plans, healthcare […]
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Recent-survey-reveals-a-shortfall-in-medical-billing-quality

Study Reveals Shocking Lack of Medical Billing Quality in US Hospitals

The Healthcare industry 2022 survey found that most hospitals fail to meet new billing measures. There is a shortage of qualified billing representatives at most hospitals, and patient itemized bills are not issued on time. Based on the Healthcare Industry survey’s new measures added in 2022, a study published in Healthcare media examined the quality […]
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Surprise-Billing-Dispute-Resolution

Surprise Billing Dispute Resolution: Challenges, Lawsuits, and Proposed Changes

This year, the CMS has frequently halted and resumed arbitration due to court cases causing disruptions in the regulatory process aimed at settling surprise billing disputes. Summary Overview: Last Friday, the CMS finalized its revamp of the No Surprises Act resolution process, fully reopening the portal for resolving disputes, including batched and single disputes for […]
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The True Cost of Claim Denials in Healthcare

The True Cost of Claim Denials in Healthcare

According to a survey, claim denials are considered the biggest obstacle in revenue cycle management, with over 20% of providers reporting an annual loss of $500K due to these denials. A recent survey of healthcare leaders conducted by leading medical billing company revealed that claim denials are causing a significant and costly issue for healthcare […]
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