Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Healthcare Revenue Cycle

Children’s Hospitals Vulnerable to Uncompensated Care Cuts

by Jacqueline Belliveau

Pediatric healthcare providers, especially those practicing in free-standing children’s hospitals, could face serious financial setbacks following upcoming uncompensated care payment reductions as mandated by the Affordable Care Act, a...

AHA Urges CMS to Withdraw Uncompensated Care Payment Changes

by Jacqueline Belliveau

The American Hospital Association (AHA) recently penned a letter to CMS Acting Administrator Andy Slavitt urging the federal agency to withdraw its proposed rule to include third-party payments, such as private payer and Medicare reimbursements,...

Value-Based Care Spurs Higher Physician Consolidation Rates

by Jacqueline Belliveau

More healthcare providers are moving to larger group practices in order to gain access to more resources to effectively implement value-based care and risk-based reimbursement models, according to a recent Datawatch report in Health Affairs....

WEDI Guide Suggests New Electronic Fund Transfer, ERA Standards

by Jacqueline Belliveau

The Workgroup for Electronic Data Interchange (WEDI) recently released a guide that advised all healthcare stakeholders to implement Automated Clearing House (ACH) Electronic Funds Transfers (EFT) and Electronic Remittance Advice (ERA) standards...

How a Small Hospital Developed Lean Supply Chain Management

by Jacqueline Belliveau

When hospitals start to dig into how their organizations can reduce healthcare costs without lowering care quality, many run the risk of overlooking several cost-cutting opportunities in their healthcare supply chain management process. But developing...

Reducing Use of Low-Value Services Cuts Healthcare Costs

by Jacqueline Belliveau

Providers can substantially lower their healthcare costs by reducing the use of low-value services, even though these services account for a substantially small portion of healthcare spending, according to a recent study by the RAND Corporation...

Group Calls for Off-Label Drug Claims Reimbursement Guide

by Jacqueline Belliveau

The federal government should develop a single resource that clarifies what off-label drug uses would qualify for federally-funded claims reimbursement, researchers stated in a recent study in the Journal of the American Medical Association....

CMS Must Inform Providers on New Medicare Reimbursement Policy

by Jacqueline Belliveau

A Vermont judge has ordered CMS to further educate providers and auditors about a recent Medicare reimbursement policy that affects skilled nursing and rehabilitation facilities, reported the Center for Medicare Advocacy. The court stated that...

How the Affordable Care Act Impacted Healthcare Revenue Cycle

by Jacqueline Belliveau

From the transition to value-based care to the rise in patient consumerism, the Affordable Care Act has significantly changed the healthcare revenue cycle management landscape since its passage in 2010. Healthcare providers restructured how they...

AHA: Limiting Low-Value Medical Resource Use Cuts Healthcare Costs

by Jacqueline Belliveau

While it is always reassuring to know that a provider will stop at nothing to diagnosis and treat his patients, limiting some medical resource use may actually help to decrease healthcare costs and improve quality of life for some patients, reported...

Team-Based Primary Care Cuts FFS Healthcare Revenue by 2.5%

by Jacqueline Belliveau

As healthcare providers continue to transition to value-based care, many hospitals and physician practices have focused on how to improve care coordination and team-based approaches to improve patient outcomes and boost their healthcare revenue...

Healthcare Employment Increases Challenge Provider Orgs

by Jacqueline Belliveau

Despite significant increases in healthcare employment rates this year, employers and providers are still facing many challenges when it comes to delivering high quality care, such as physician burnout and rising turnover rates. A recent report...

Exploring the Role of Supply Chain Management in Healthcare

by Jacqueline Belliveau

Cutting healthcare costs has become a mantra for many hospitals and physician practices, especially as payers start to tie claims reimbursement amounts to quality and cost performance. Many organizations have looked to the billing and services...

4 Medical Billing Issues Affecting Healthcare Revenue Cycle

by Jacqueline Belliveau

Medical billing is the backbone of healthcare revenue cycle management, but many providers experience significant challenges with efficiently and accurately billing patients and payers for services they perform. The medical billing process can...

88% Improve Claims Submissions Using Revenue Cycle Analytics

by Jacqueline Belliveau

According to a Navicure survey, medical organizations that used a revenue cycle analytics or business intelligence solution were able to boost performance on key healthcare revenue cycle metrics. About 88 percent of participants reported that...

Healthcare Costs Concerns Impact Provider Rationing Behavior

by Jacqueline Belliveau

It is not uncommon to hear patients say that healthcare costs are going up, especially as more individuals enroll in high-deductible health plans. But, some providers oftentimes question if they should be responsible for helping to control costs....

Cerner to Increase Focus on Value-Based Reimbursement

by Kyle Murphy, PhD

Cerner has named Adventist Health System's Jeff Hurst to oversee its revenue cycle management division, the company announced Tuesday. Hurst, who currently serves as Florida Hospital's Senior Vice President of Finance at Florida Hospital...

FTC: States Should Avoid Agreement Laws on Hospital Mergers

by Jacqueline Belliveau

The Federal Trade Commission has made clear its stance on certain state laws governing hospital mergers while at the same time dismissing a complaint against the merger of Cabell Huntington Hospital and St. Mary’s Medical Center. The federal...

31% of Providers Still Use Manual Claims Denial Management

by Jacqueline Belliveau

As the transition to value-based care carries on, many healthcare providers are reexamining their current healthcare revenue cycles to account for new alternative payment models. With providers experiencing an increase in claims denials and denial...

CMS: Proposed Changes to Dialysis, ESRD Claims Reimbursement

by Jacqueline Belliveau

The Centers for Medicare and Medicaid Services (CMS) has recently announced proposed changes to claims reimbursement models for end-stage renal disease (ESRD) and dialysis as well as revisions to the competitive bidding program for durable medical...


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