Medical Billing

Patient Collection Rate Falls to Nearly 48%

February 28, 2024 - Healthcare organizations are finding it harder to collect patient financial responsibility, a new analysis from Kodiak Solutions indicates. The analysis of patient financial transactions from over 1,850 hospitals and 250,000 physicians nationwide showed a sharp decline in the patient collection rate, from 54.8 percent in 2021 to just 47.8 percent...


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Breaking Down the Back-End Revenue Cycle, Key Best Practices

by Jacqueline LaPointe

The healthcare revenue cycle is a continuous process that relies on each step to keep revenue flowing. However, many organizations break down the revenue cycle into front- and back-end steps to manage what happens before and after a...

How AI is Becoming a Staple in Medical Coding, Auditing

by Jacqueline LaPointe

Troves of data flow through the healthcare revenue cycle. Yet, many providers struggle to make sense of the codes and clinical documentation to not only submit clean claims but also understand patient encounters that occur within their...

Medical Billing Quality Lacking According to Leapfrog Measures

by Jacqueline LaPointe

Most hospitals do not have high medical billing quality, including patient access to a qualified billing representative and timely itemized billing statements. A recent study published in JAMA...

Feds Finalizes $115 Participation, Other Fees for IDR Process

by Jacqueline LaPointe

The Departments of Health and Human Services, Labor, and the Treasury (the Departments) have updated the amount each party must pay to resolve surprise medical bills through the federal independent...

Providers See Fourfold Increase in External Payer Audits

by Jacqueline LaPointe

2023 has been a big year for healthcare revenue integrity, with teams managing about four times more external payer audits in the last year. The finding from the latest “MDaudit Annual Benchmark...

Fewer Than 1 in 3 Consumers Pay Medical Bills Immediately

by Jacqueline LaPointe

Healthcare revenue cycle leaders may need to readjust their patient collection strategy to help consumers understand and pay their medical bills, a new survey suggests. The survey of over 1,000...

27% of Adults Face At Least One Healthcare Affordability Challenge

by Jacqueline LaPointe

Healthcare affordability is significantly impacting low- and middle-income families, but healthcare financial strain is becoming a more widespread issue for US families, a new study published in Health...

Consumer Credit Scores Improve After Medical Debt is Wiped from Reports

by Victoria Bailey

After major credit bureaus stopped reporting medical debt collections less than a year old and less than $500, consumers saw improvements in their credit scores, according to data from the Urban...

Surprise Billing Proposals Aim to Streamline IDR Process

by Victoria Bailey

The Biden-Harris Administration has released a proposed rule to improve the independent dispute resolution (IDR) process for surprise billing by addressing payer-provider communication and adjusting...

How Do Healthcare Organizations Feel About Autonomous Coding?

by Victoria Bailey

Autonomous coding can help streamline revenue cycle processes and reduce administrative burden, but over half of surveyed healthcare finance leaders are not familiar with it, while others do not fully...

AMA 2024 CPT Code Set Addresses Language Barriers, Immunization Codes

by Victoria Bailey

The American Medical Association (AMA) has released the 2024 Current Procedural Terminology (CPT) code set, which addresses language barriers by including Spanish descriptors of medical services. Each...

What the Latest Court Decisions Mean for the Federal IDR Process

by Jacqueline LaPointe

The latest court rulings in a series of legal challenges have left the No Surprises Act’s (NSA’s) federal independent dispute resolution (IDR) process in limbo yet again. In an announcement on the CMS website on August 25th,...

Key Ways to Boost Collection of Patient Financial Responsibility

by Jacqueline LaPointe

Patient financial responsibility keeps growing, creating challenges for healthcare organizations looking to collect all revenue for services provided to patients. According to the latest “KFF Employer Benefits Survey,” the...

Allina Health Ends Medical Billing Practice Based on Past-Due Debt

by Victoria Bailey

Nonprofit health system Allina Healthcare will end its medical billing practice of denying non-emergency care to patients with medical debt, the New York Times reported. The policy change comes...

Middle-Class Americans Face Highest Rates of Medical Debt Burden

by Victoria Bailey

Middle-class Americans have the most medical debt across all ages, races, and education levels, a new report found. The report from think tank organization Third Way used the Census’s Survey of...

CMS Reduces No Surprises Act Fee After Court Vacates Price Hike

by Jacqueline LaPointe

CMS has reinstated the $50 fee for initiating a payment dispute under the No Surprises Act following a court ruling striking down a price hike earlier this year. The non-refundable administrative fee...

As Patient Financial Responsibility Grows, Technology Key to Collections

by Jacqueline LaPointe

You may not want to think about the new year just yet. But if you don’t have a patient payment solution in place now, you might be sorry come January. Patient financial responsibility has hit all-time highs over the last decade,...

Medical Debt Unevenly Impacts People of Color, Low-Income Residents in NY

by Victoria Bailey

Medical debt in New York State varied widely by geography in 2022, with debt more common among communities of color and those with low incomes, highlighting disparities. The Urban Institute report...