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

Revenue Cycle Management

How to Address Bundled Payment Cost Reduction Challenges

by Jacqueline DiChiara

As per the Affordable Care Act (ACA), the Centers for Medicare & Medicaid Services (CMS) will begin applying a value-based payment program under the physician fee schedule within the year in association with budget neutrality. This November,...

12 Value-Based Reimbursement Strategies to Cut Revenue Risk

by Jacqueline DiChiara

Value-based reimbursement is a hearty healthcare subject worth diving into as the shift from volume to value continues to evolve. Thirty percent of Medicare payments will be tied to alternative payment models, as per a recent announcement from...

How Mass General Hospital Excels in Revenue Cycle Management

by Jacqueline DiChiara

“How do you excel in revenue cycle management?” continues to ask hospital executives and leaders this simple yet intricate question to help advance the healthcare industry. As...

3 ICD-10 Changes Include Specificity, Expansion, Combination

by Jacqueline DiChiara

ICD-10 is almost here, with only 43 days remaining. Of paramount significance come October 1 when ICD-10 implementation swings into full gear is a keen and clear understanding of what will be different this time around. The following is a narrowed...

Healthcare Consumers Lack Transparency, Price Info Awareness

by Jacqueline DiChiara

Many obstacles impede healthcare consumers from acquiring high quality healthcare. Many healthcare consumers are unaware of the idea of price transparency. Still, many healthcare consumers yearn for more information about the cost of their healthcare,...

CMS Adds Pilot Project Participants to Reduce Medicare Costs

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has announced over 2,100 acute care hospitals, skilled nursing facilities, physician group practices, long-term care hospitals, inpatient rehabilitation facilities, and home health agencies...

CMS Answers 5 ICD-10 Coding, Reimbursement, Test Questions

by Jacqueline DiChiara

ICD-10 implementation formally kicks off in less than 50 days. To aid the healthcare industry with the upcoming transition and promote the dissemination of accurate, intelligent information, the Centers for Medicare & Medicaid (CMS) has released...

3 Simple Things to Know About Healthcare Spending’s Future

by Jacqueline DiChiara

Predicting the delicate future of healthcare cost and spending trends based on past algorithms, collected data implications, and the simple art of a strong financial guess based on knowledge and skill sets is an important aspect of understanding...

Does Improved Care Access, Insurance Coverage Stem from ACA?

by Jacqueline DiChiara

Can the Affordable Care Act (ACA) be considered a success? According to data analysis published in The Journal of the American Medical Association, the answer is a hearty yes. Although the time prior to the ACA’s initial enrollment period...

“Enormous” Impact When Radiologists’ ICD-10 Codes Sextuple?

by Jacqueline DiChiara

There are nearly 35,000 practicing radiologists, many of whom rely on referring physicians’ diagnostic information. The amount of ICD-10 codes radiologists handle will increase six-fold come October 1, confirms new research. The future...

ICD-1 to ICD-11 Timeline Highlights Healthcare’s Evolution

by Jacqueline DiChiara

Considering the past developments of ICD-10 – the tenth revision of the International Classification of Diseases – is imperative to best comprehend what’s next for the healthcare industry. From ICD-9’s inception via The...

August 7: Week That Was in Healthcare Fraud and Malpractice

by Jacqueline DiChiara

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars...

3 Tips to Retain Coders’ Productivity Post-ICD-10 Transition

by Jacqueline DiChiara

Will a projected decline in coding efficiency become reality, perhaps caused by ICD-10’s greater specificity and high code volume? Will ICD-10's implementation kick off with a financial bang or merely...

CMS, Rhode Island Announce New Medicare-Medicaid Care Model

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) announced a partnering with the state of Rhode Island last Thursday to test a new model for supporting Medicare-Medicaid enrollees by advocating for a more harmoniously executed, people-focused...

Engaging Physicians in Supply Chain Transparency Opportunity

by Jacqueline DiChiara

Supply chain management and revenue cycle management are generally approached as independent entities within the healthcare realm. Is this necessarily the best approach? As reported, although enhanced cost-to-cost charge...

WEDI ICD-10 Readiness Survey Recommends HHS Compliancy

by Jacqueline DiChiara

As ICD-10’s spotlight beams brighter with nearly 50 days remaining until its formal implementation, the big question is – will October 2 be the beginning of a revenue cycle downward death spiral or merely just another uneventful Friday?...

4,000 Healthcare Providers Receive $54M for HEDIS Excellence

by Jacqueline DiChiara

Physicians are demonstrating their continued dedication to advancing the quality of healthcare and helping Medicare Advantage members receive optimum treatment and are getting paid accordingly for doing so. UnitedHealthcare recently distributed...

Is the ACA Working as Intended to Improve Healthcare Access?

by Jacqueline DiChiara

Is the Affordable Care Act (ACA) living up to its full potential or is it more a matter of all healthcare hands on deck? In past interviews with, healthcare experts and leaders from both athenahealth and the Robert...

Will Medicare Part D Prescription Drug Plans Stabilize?

by Jacqueline DiChiara

As Medicare – established along with Medicaid on July 30, 1965 – formally hits its 5-decade anniversary this week, the healthcare industry turns over a new financial leaf upon considering where new spending and saving focuses...

How Can Hospitals Refocus Cost Reduction, Payment Tactics?

by Jacqueline DiChiara

As hospitals consider various ways to strengthen their revenue cycle, they may be focusing on the wrong places while overlooking the right places. As the expansion of hospital acquisition and mergers continues with more vigor, healthcare costs...


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