Tag: RCM Services

Power of Healthcare Revenue Cycle Management in 2024

Power of Healthcare Revenue Cycle Management in 2024

In the intricate realm of healthcare, where patient well-being is closely entwined with administrative complexities, the cornerstones of success lie in effective revenue management and specialized revenue cycle management services. This pivotal link between clinical operations and financial viability is established through the practice of healthcare revenue cycle management (RCM) and services offered by specialized […]
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5 Benefits of Addressing Payment Integrity Before Payments Are Ever Made

5 Benefits of Addressing Payment Integrity Before Payments Are Ever Made

Payment integrity in Medicaid—the concerted effort to keep tight control over fraud, waste and abuse—can be addressed at any stage in the claim cycle. Of course, the earlier it is addressed, the easier it is for health plans to avoid improper payments and the administrative burden of recovering them. And while pre-payment integrity programs maximize […]
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Medicare advantage prior authorizations are often unnecessarily denied

Medicare advantage prior authorizations are often unnecessarily denied

  A report by the Office of Inspector General (OIG) raises concerns about organizations prioritizing profits over patient access to care. Medicare Advantage organizations (MAOs) often delay or deny services for medically necessary care, even when prior authorization requests meet coverage rules, according to a report by the OIG. A concern with the Medicare Advantage […]
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AMA Urges Congress to Update Medicare Physician Payment System

AMA Urges Congress to Update Medicare Physician Payment System

The American Medical Association urged congressional leaders to lift the freeze on Medicare physician payments and provide updates that reflect inflation and practice costs. Following a recent Medicare Payment Advisory Commission (MedPAC) report, the American Medical Association (AMA) has asked Congress to update the Medicare physician payment system to include a stable annual payment rate […]
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Healthcare Tech Company Launches Online Price Transparency Tool

Healthcare Tech Company Launches Online Price Transparency Tool

Through the online price transparency tool, users can view hospital service prices and assess machine-readable file completeness. A healthcare technology company has launched an online price transparency tool that allows consumers to compare hospital costs before seeking care. Turquoise Health’s Price Transparency Scorecard lets consumers find prices by searching for specific services or providers. The […]
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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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9 Challenges funding can help your medical practice overcome

9 Challenges funding can help your medical practice overcome

Proper funding can help your practice to rise above some challenges. 9 Challenges funding can help your medical practice overcome Medical practice funding is often best used to support growth initiatives that will increase your practice’s revenue—thus increasing the chance that you’ll be able to pay off your loan on time. However, sometimes medical practices […]
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Medicare Advantage Plans Boost Supplemental Benefits Offerings

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

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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