Tag: RCM Services

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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Medicare Advantage Plans Boost Supplemental Benefits Offerings

Medicare Advantage plans expanded their supplemental benefits offerings in 2022, with more health plans offering special supplemental benefits for the chronically ill (SSBCI), according to an issue brief commissioned by Better Medicare Alliance. Medicare beneficiaries typically join Medicare Advantage plans because of the array of supplemental benefits that the program offers in addition to traditional […]
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Federal Court Strikes Portions of Regulations Implementing No Surprises Act

  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 […]
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National Healthcare Spending, Prices Saw Modest Increase in 2021

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 […]
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The one trick to negotiating reimbursement rates

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. […]
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The Clock Is Ticking: HIPAA Small Breach Notifications Due March 1st

March 1, 2022, is the date by which HIPAA-covered entities must notify the U.S. Department of Health and Human Services Office for Civil Rights (OCR) of “small” breaches of unsecured protected health information that were discovered during calendar-year 2021. A small breach involves fewer than 500 individuals. HIPAA Small Breach Notification Requirements HIPAA requires covered […]
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Build your financial success dream team

Many busy physicians find they don’t have the time and energy to develop a savvy financial plan for their practice or their own personal needs. That’s why physicians needs the collaborative support and guidance of a good financial team. Many physicians never learned anything in medical school about running a business or handling personal finances, […]
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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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