Tag: Prior Authorization

Three Ways to Outsmart Denials in 2023

Three Ways to Outsmart Denials in 2023

Denial rates serve as a barometer for the financial well-being of healthcare organizations. An increase in denials can have wide-ranging negative implications for an organization — impacting everything from accounts receivable to the patient experience. By preventing denials upfront, providers can realize revenue faster, boost staff efficiency and satisfaction, and reduce patient anxiety related to […]
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CMS Aims To Streamline Prior Authorization To Reform MA

CMS Aims To Streamline Prior Authorization To Reform MA

The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA). In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing. The Biden administration has shown a commitment to increasing oversight of […]
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Prior Authorization Reform in Medicare Advantage

Prior Authorization Reform in Medicare Advantage

Prior Authorization reform in Medicare Advantage would help relieve administrative burden for medical groups and reduce patient care delays, MGMA said. The Medical Group Management Association (MGMA) has urged CMS to implement policies that support prior authorization reform and value-based care contracts within the Medicare Advantage program. MGMA submitted comments to CMS Administrator in response […]
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AHA Asks CMS to Waive Medicare Advantage Prior Authorization During PHE

AHA Asks CMS to Waive Medicare Advantage Prior Authorization During PHE

CMS encouraged Medicare Advantage plans to waive prior authorizations during the public health emergency, but AHA urged the agency to make it a requirement instead of a suggestion. The American Hospital Association (AHA) has asked CMS to work with Congress and require Medicare Advantage plans to waive prior authorization processes during the current and future […]
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AMA: Prior Authorization Creates Physician Burden, Patient Care Delays

AMA: Prior Authorization Creates Physician Burden, Patient Care Delays

Although health plans aim to promote value-based care with prior authorization requirements, providers and patients may experience negative repercussions from the process. Prior authorization negatively impacted patients and providers alike by leading to care delays for patients and creating administrative burden for physicians, according to a survey from the American Medical Association (AMA). Health plans […]
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Robotic Process Automation_ The Future of Healthcare Revenue Cycle Management

Robotic Process Automation: The Future of Healthcare Revenue Cycle Management

As RPA’s value for revenue cycle continues to be explored, leaders need to go beyond the hype and determine a practical path to innovation that takes into account the organization’s capacity for innovation and the road map that will best take the organization to its desired digital destination. A recent survey shows 15% of healthcare revenue cycle […]
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