Educated guesses and imprecise, stopgap efforts aren’t enough. Revenue cycles need precise strategies to identify exactly where leakage occurs and implement solid processes to stop leakage before it starts. Even before COVID-19, 250-bed hospitals lost $4.7–$11 million a year from mid–revenue cycle leakage. Now, pandemic-fueled volume losses and razor-thin margins mean that hospitals can no […]
Hospital financial performance improved in April, but margins are still thin as hospital revenue recovers from COVID-19, a report from Kaufman Hall shows. Hospital revenue, volumes, and margins increased in April 2021 both year-to-date and year-over-year, but have a long way to go in terms of COVID-19 recovery, according to a report by health care […]
Previously delayed from March 15th to May 15th, the final rule will now be codified on December 15th, giving CMS time to tackle issues raised by stakeholders. CMS announced that it will delay the effective date of a final rule updating the definition of “reasonable and necessary” and the guidelines surrounding the Medicare Coverage of […]
It’s critical that independent practices make sure that they are laying the groundwork to make telehealth a robust part of their care delivery and their bottom line. In a very real sense, telehealth has been responsible for enabling independent healthcare practices to stay in practice and continue to provide care to their communities during […]
ACHP provides several steps that will leverage the advancements of the Affordable Care Act and increase access to high-quality coverage and care. The Alliance of Community Health Plans (ACHP) released recommended steps to build on the success of the Affordable Care Act (ACA) and enhance and expand coverage in the individual health insurance market. First, […]
The Centers for Medicare & Medicaid Services has sent its first wave of warning letters out to hospitals breaking federal rules requiring them to disclose payer-negotiated prices, a spokesperson for the agency confirmed. CMS has been auditing hospitals’ websites and complaint submissions since the rule went into effect on January 1 and began sending out […]
On April 27, 2021, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule for the fiscal year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS). The proposed rule includes CMS proposals for certain annual Medicare payment policies and rates as well as certain quality and value-based programs for FY 2022. Stakeholders must submit […]
Patient access is the first point of contact for patients and the first time staff can get key information right for revenue cycle management success. Patient access is generally the first encounter a patient will have with a healthcare organization, making it central to the patient experience. But this aspect of healthcare is also […]
Claims management is a multi-step process that provides ample opportunity for errors and delays, but if payers modify their approach to certain steps in the process it could have a positive impact overall. In the most concise language, claims management starts with a provider sending a claim or prior authorization request to a payer. The […]
Physicians enter into health care because they want to help care for patients, not to become business people. This can make revenue cycle management (RCM) seem like an overwhelming or complex set of steps, yet, at its essence, “it is basically about obtaining payment for services rendered to a patient,” says Kelly Dingwell, principal attorney […]