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

Revenue Cycle Management

Subsidies Upheld, State-Run Exchanges Face Funding Issues

by Jacqueline DiChiara

The King v. Burwell ruling will likely be the last major hurdle the Affordable Care Act (ACA) faces from court challenges. Says Bill Melville, Market Analyst for Decision Resources Group, to, even if subsidies are upheld...

June 26: 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...

Will ICD-10 Recovery Bring Artificial Medical Cost Inflation?

by Jacqueline DiChiara

As the healthcare industry enters the second half of the year with the rise and fall of the summer solstice this week, 100 days remain until the onset of ICD-10 implementation. Priorities for healthcare providers are changing as time ticks onwards....

Healthcare Supply Chain Transparency May Save Billions in Waste

by Jacqueline DiChiara

The evolving connection between healthcare supply chain and revenue cycle management is yet to be explored. As reported, an innovative discipline level within the healthcare supply chain realm is emerging as healthcare...

Cigna Rejects Anthem’s ‘Woefully Skewed’ $53.8B Proposal

by Jacqueline DiChiara

The largest ever proposed health insurance merger perhaps falls short. Anthem, Inc announced its submission this week of a highly conditional, non-binding $53.8 billion proposal, including debt, to acquire Cigna Corporation for $184 per share...

How does the ACA Impact Providers’ Trust of Payers?

by Jacqueline DiChiara

How are those healthcare payers participating in Affordable Care Act (ACA) implementation performing? Perhaps pretty well, according to a tenth annual PayerView report card and ninth annual Payer Trust Index released consecutively by athenahealth...

Is ICD-10 Implementation a Favorable Change Worth Making?

by Jacqueline DiChiara

Are you experiencing problems with your in-laws? There’s an ICD-10 code for that. Did your water skis catch on fire again? There’s an ICD-10 code for that, too. Injured while vacationing in outer space? An ICD-10 code indeed exists....

ICD-10 Implementation is a Reimbursement Risk for Physicians

by Jacqueline DiChiara

ICD-10 delay and implementation news is on the tip of many a healthcare executive’s tongue. With the possibility of an upcoming ICD-10 implementation freeze, swirling industry-wide confusion, anticipated revenue cycle disturbance, and a...

ACOs Fighting Revenue Cycle Setbacks, Says Black Book Survey

by Jacqueline DiChiara

The fastidious partnership of financial incentive and risk is a delicate balancing act the healthcare industry is now increasingly pressured to perfect. As the healthcare system expediently swings away from fee-for-service and into the realm...

CMS’s Internal Controls Neglect Payment Accuracy under ACA

by Jacqueline DiChiara

The internal controls that calculate and authorize financial assistance payments on behalf of the Centers for Medicare & Medicaid Services (CMS) are failing, says a report from the Office of the Inspector General (OIG)....

Coalition for ICD-10: Safe Harbor ‘Dangerous’ for Physicians

by Jacqueline DiChiara

A two-year ICD-10 “grace period” recently proposed by the House of Representatives, among a slew of similarly introduced bills, will result in unnecessary disaster for the healthcare delivery system, says the Coalition for ICD-10....

Will Enterprise-Wide System Data Bulletproof Revenue Cycle?

by Jacqueline DiChiara

The world of revenue cycle management possibly involves more variables than an introductory algebra course. The process of getting a professional claim paid often involves the execution of allegedly miraculous events. Bullet proofing a claim...

CMS Explores ICD-10 Scenarios with Interactive Case Studies

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has released a series of interactive case studies intended to enhance and advance the healthcare industry’s collective ICD-10 documentation comprehension. The ICD-10 countdown is formally...

ICD-TEN Act Ensures Reasonable, Responsible ICD-10 Transition

by Jacqueline DiChiara

The ICD-10 implementation deadline is up for review with the recent push for a new bill from Representative Diane Black (R-TN) and the House of Representatives – the Increasing Clarity for Doctors by Transitioning Effectively Now Act (ICD-TEN...

State Lawmakers, AMA, Back ICD-10 ‘Grace Period’ House Bill

by Jacqueline DiChiara

State lawmakers are pleading with Congress to actively mandate an ICD-10 delay. Such initiatives follow the announcement of a recently proposed bill from the House of Representatives – the Protecting Patients and Physicians...

Revenue Cycle Management, EHR Vendor Loyalty Gaining Momentum

by Jacqueline DiChiara

Revenue cycle management and integrated Electronic Health Records (EHR) vendor loyalty for smaller physician practices continue to flourish and thrive within the healthcare industry, confirms an annual 2015 Black Book survey released in today’s...

CMS Finalizes ACO Medicare Shared Savings Program Rules

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) announces a final rule updating the Medicare Shared Savings Program. The primary objective of CMS’s actions is to promote high quality care delivery for Medicare beneficiaries...

Is Consumer-Centric Revenue Cycle Management the Solution?

by Jacqueline DiChiara

Is revenue cycle management in need of a drastic overhaul? As the ever evolving landscape of the healthcare industry continuously adjusts its sails, revenue cycle management may be continuously falling backwards amidst antiquated winds. A...

Does a Half Billion HIE Investment Create ROI?

by Jacqueline DiChiara

Following a decade of healthcare’s investment in health information exchange (HIE) platforms, the healthcare industry enters a state of reflection and analysis regarding what the return on investment implications may be. The Office of the...

Healthcare Experts’ Top 5 Accountable Care Organization Tips

by Jacqueline DiChiara

Accountable care organizations (ACOs) and accountable care models have existed on the forefront of the healthcare industry as an emerging and dynamic focus for healthcare providers, payers, and executives. As recent initiatives within the past...


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