In today’s digital age, patient health information (PHI) is increasingly stored and managed electronically. While this shift improves efficiency and accessibility in healthcare, it also introduces significant data privacy and security challenges. One critical area of concern is healthcare data breach—incidents where patient data is accessed, disclosed, or stolen without authorization. Under the Health Insurance […]
Medicare Open Enrollment is a critical period for millions of Americans, running annually from October 15th to December 7th. During this time, Medicare beneficiaries have the opportunity to review and make changes to their health and prescription drug plans for the upcoming year, with new coverage taking effect on January 1st. For health payers, this […]
With over 67 million Americans—nearly 20% of the population—relying on Medicare, the program plays a crucial role in ensuring access to quality healthcare. Unfortunately, looming Medicare physician reimbursement cuts threaten to undermine this vital service, potentially leading to reduced access to care and compromised patient outcomes Medicare physician reimbursement cuts, such as the proposed 2.8% […]
Managing denied claims remains one of the most challenging challenges for healthcare providers and Revenue Cycle Management (RCM) professionals as healthcare reimbursement models continue to evolve. As well as delaying payments, claim denials contribute to administrative burdens, reduced cash flow, and significant revenue losses. Medicare denial rates are approximately 10%, according to the American Medical […]
Ideally, revenue cycle processes should flow seamlessly from one stage to the next. However, challenges can arise at any point, from the front end to the back end, requiring leaders to be vigilant and strategic in their efforts. Here are some highlighting executive approaches to various revenue cycle challenges: How Healthcare Services Revamped Their Billing […]
In 2024, factors like declining reimbursement rates, the shift towards value-based care, and ever-changing regulations demand a proactive approach to improve RCM. Here, we explore four key strategies to optimize your healthcare revenue cycle and ensure financial stability in the coming year. 1. Break down Silos: Merging Front-End and Back-End Functions Many healthcare organizations struggle […]
On Wednesday, February 23, 2022, a federal court in Texas struck down five controversial portions of the interim final rule (“Rule”) jointly issued by three federal executive agencies (“Departments”) that implement the independent dispute resolution (“IDR”) process of the No Surprises Act (“NSA”). The portions of the Rule at issue set forth certain parameters […]
The third batch of Phase 4 COVID-19 Provider Relief Funds will offer $560 million to 4,100 providers who faced revenue loss during the pandemic and serve vulnerable populations. HHS is distributing another $560 million in Provider Relief Fund Phase 4 payments to over 4,100 healthcare providers that have been affected by the COVID-19 pandemic. Provider […]
National healthcare spending increased by 3.4 percent in 2021, while the Health Care Price Index (HCPI) maintained a year-over-year growth of around 2 percent, according to Altarum’s February 2022 Health Sector Economic Indicators (HSEI) briefs. Unlike the December 2021 and January 2022 briefs, Altarum included federal government expenditures in the February data, which significantly impacted […]
Honing your approach when negotiating with insurers can lead to better reimbursement rates. Last I checked my plumber charges me more than some physicians make for some services. It’s not to say that plumbers don’t work hard, but they certainly didn’t have to invest an inordinate amount of time and money to get specialized degrees. […]