Revenue Cycle Management Archives - Page 19 of 24

Are you a HIPAA entity? The “Privacy Law” May not Be What you Think

The first thing you should know about HIPAA is that it’s HIPAA, not HIPPA, as is commonly seen. There is only one “P,” and that “P” doesn’t stand for “privacy.” If you have heard the acronym “HIPAA” (referring to the Health Insurance Portability and Accountability Act of 1996) thrown around a lot lately, you may […]

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Hospital Pros and Cons of the CY 2022 OPPS Proposed Rule

Hospital groups are digesting the 863-page CY 2022 OPPS proposed rule, but many are already commenting on new hospital price transparency penalties and other policies. The newly proposed Medicare Outpatient Prospective Payment System (OPPS) rule for calendar year (CY) 2022 is causing a stir with new hospital price transparency enforcement rules and other policies. The […]

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4 Reasons Why UnitedHealthcare’s Attempt To ‘Monday Morning Quarterback ED Claims Is ‘Bad Policy’

“It really undermines what the physicians are doing at the point of care, and it’s bad policy,” says Doug Wolfe, co-founder and partner of the Miami-based law firm Wolfe Pincavage. UnitedHealthcare’s attempt to “Monday morning quarterback” emergency room visits by retroactively denying emergency claims is not only likely a violation of the prudent layperson standard, […]

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Providers Still Want More Time to Spend COVID-19 Relief Funds

HHS recently extended the deadline to use COVID-19 relief funds to the end of the month, but some providers say they still need more time. The American Hospital Association (AHA) is seeking more time for healthcare providers with unspent COVID-19 relief funds. The deadline to use COVID-19 relief funds is approaching for many providers. According […]

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Experts Consider Impacts of SCOTUS Affordable Care Act Decision

The Supreme Court’s decision in California v Texas ended one lawsuit against the Affordable Care Act but may have left room for future legal action. Since the Supreme Court dismissed California v Texas on June 17, payers and healthcare leaders have vocalized their support for the decision, their readiness to continue building on the Affordable […]

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More than 30% of hospitals are near the ‘danger zone’ of denial rates

The pandemic has only made the trend worse, as 33% of hospital executives report average claims denial rates of 10% or more. Hospital claim denial rates have hit new highs, with a 20% increase in those rates over the past five years, suggesting that better claims denial management processes are necessary, finds a new […]

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Pros, Cons of Non-Emergency Medical Transportation Benefits

MACPAC’s June 2021 report to Congress included findings about non-emergency medical transportation benefits in Medicaid programs that could prove useful for benefits design. A small fraction of the Medicaid population utilizes non-emergency medical transportation (NEMT) benefits, but for that community of beneficiaries NEMT programs can be indispensable, a MACPAC report recently found. It has been […]

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Emergency physicians call United healthcare’s ED denial Policy ‘Dangerous’

The American College of Emergency Physicians said that it “firmly believes that the new policy is in direct violation of the federal Prudent Layperson Standard.” Calling it a “dangerous decision” and a “scare tactic,” the American College of Emergency Physicians (ACEP) is condemning UnitedHealthcare’s recent announcement to retroactively deny emergency care claims. “ACEP firmly believes […]

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5 winning financial strategies for medical practices

Physicians who institute best practices bring in more revenue and profit than those who do not, and this can be the difference between being successful and being out of business. What’s the difference between a highly successful practice and one that just gets by? Oftentimes, it comes down to focusing on a handful of key […]

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Physician Compensation Plateaus Despite Pandemic Losses

Despite a fiscally challenging year for the healthcare industry, physician compensation for most specialties has remained the same or has slightly increased, a new report from the Medical Group Management Association (MGMA) reveals. However, most specialties showed an overall decrease in productivity in 2020. The report utilized data from 185,000 providers spanning over 6,700 organizations, […]

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Tag: Revenue Cycle Management

Are you a HIPAA entity? The “Privacy Law” May not Be What you Think

Hospital Pros and Cons of the CY 2022 OPPS Proposed Rule

4 Reasons Why UnitedHealthcare’s Attempt To ‘Monday Morning Quarterback ED Claims Is ‘Bad Policy’

Providers Still Want More Time to Spend COVID-19 Relief Funds

Experts Consider Impacts of SCOTUS Affordable Care Act Decision

More than 30% of hospitals are near the ‘danger zone’ of denial rates

Pros, Cons of Non-Emergency Medical Transportation Benefits

Emergency physicians call United healthcare’s ED denial Policy ‘Dangerous’

5 winning financial strategies for medical practices

Physician Compensation Plateaus Despite Pandemic Losses

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