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

Revenue Cycle Management

Top 4 Strategies to Achieve Affordable Value-Based Care

by Jacqueline DiChiara

Value over volume is the name of the revenue cycle game, with the reimbursement concept of “less is more” taking precedence. With the transition to value-based care underway, here are some top collected strategies for healthcare providers...

Nov. 20: 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...

Senate Committee Approves Rural Health Care Connectivity Act

by Jacqueline DiChiara

Those living in rural areas of the country without a hospital delivering affordable care nearby may soon be at ease due to passage of a new bipartisan bill. United States Senator John Thune (R-SD), Chairman of the Senate Committee on Commerce,...

KLAS Research Assesses Providers’ Value-Based Care Focus

by Jacqueline DiChiara

Healthcare providers must balance needs versus capabilities in the midst of stark competition, according to a newly released KLAS performance report. KLAS’s research assesses the overall effect of both value-based care consulting and...

Pew Urges CMS to Consider Physician-Focused Payment Models

by Jacqueline DiChiara

Lack of financial reimbursement may be preventing physicians from initiating imperative end-of-life discussions about a patient’s definitive health desires and wishes. The Pew Charitable Trusts (Pew) is concerned with the lack...

Why ICD-10 Coding Demands a Focused Compliance Perspective

by Jacqueline DiChiara

Now that mid-November is here, healthcare entities should be prepared to respond to aggressive audits and clinical documentation enforcement efforts regarding ICD-10 code selections, or will face fraudulent billing claims. Such stated George...

Low Reimbursement, High Costs Threaten Physician RCM Success

by Jacqueline DiChiara

The three leading concerns among physicians' predictions regarding profitability drops are declining reimbursements, increasing personnel expenses, and issues regarding supplies, says CareCloud’s recently released third annual...

GAO to CMS: State Medicaid Payment Flaws Hurt Transparency

by Jacqueline DiChiara

The reliability regarding tens of billions of dollars in states’ supplemental payments is being called into question this month by the United States Government Accountability Office (GAO). Because complete reliable data is deficient, transparency...

How a Cadillac Tax Repeal Affects Revenue Cycle Management

by Jacqueline DiChiara

Repeal of the Cadillac Tax – a tax on high-cost healthcare insurance plans some private companies offer to employees – is up for debate once more, especially among recent presidential debate conversation and household...

Healthcare Consumers Demand More Coverage Comparison Options

by Jacqueline DiChiara

A new pilot initiative involving a “Doctor Lookup” feature is now available for some healthcare consumers’ online perusal. Such a beta feature lets healthcare consumers compare coverage options in association with their individual...

Senators Push Tax Deductions for Healthy Lifestyle Choices

by Jacqueline DiChiara

Would being paid to purchase a new gym membership promote you to take up a new workout routine? Such a concept may soon become a reality, even without a government mandated initiative. Last week, four United States Senators – John Thune...

Cigna-HealthSpring, UPHS Confirm Network Expansion Agreement

by Jacqueline DiChiara

Cigna-HealthSpring and The University of Pennsylvania Health System (UPHS) have announced new collaboration efforts to expand a 2016 network relationship agreement and provide supplementary resources and a series of well-coordinated incentives....

Is U.S. Healthcare Really a Big Spender in Global Contrast?

by Jacqueline DiChiara

Healthcare spending nationwide is more expensive in comparison with our international neighbors due to greater medical technology implementation and higher healthcare prices, confirms a Commonwealth Fund issue brief. But is the U.S. really that...

How Does Meaningful Use Impact Revenue Cycle Management?

by Jacqueline DiChiara

Several questions are imperative to consider in terms of recent news related to the long-awaited final use for meaningful use modifications and Stage 3 Meaningful Use requirements: How meaningful is meaningful use when it comes to revenue...

PA Receives $886K Award in CCBHC Behavioral Disorder Funding

by Jacqueline DiChiara

It is perhaps becoming increasingly difficult to peruse the news without stumbling across a story on behavioral health. Whether bombs are falling in Boston or bullets are flying across a college campus, both political debates and Monday morning...

CMS Requests Merit-Based Incentive Payment System Discussion

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) will publish a proposed rule tomorrow (CMS-3321-NC2) requesting information about the implementation of the Merit-Based Incentive Payment System (MIPS) and allowing for a comment period...

Higher Premiums, Deductibles in 2016 Medicare Part D Plan

by Jacqueline DiChiara

Many Medicare beneficiaries may soon experience increased premiums and deductibles if they fail to change plans, confirms yesterday’s issue brief from the Henry J. Kaiser Family Foundation (Kaiser). Via an analysis of key 2015 marketplace...

86% of Physicians Say ICD-10 Diverts Focus from Patient Care

by Jacqueline DiChiara

With ICD-10 – the tenth edition of the International Classification of Diseases – implementation now a tangible reality as the healthcare industry enters mid-October, questions about ICD-10’s detrimental patient impact are beginning...

GAO Announces New Physician-Payment Model Advisory Committee

by Jacqueline DiChiara

The Government Accountability Office (GAO) has announced 11 new initial committee members appointed to the Physician-Focused Payment Model Technical Advisory Committee. Selected members, who will serve intentionally zigzagged terms...

Why Focusing on Hospital Readmission Causes Is Essential

by Jacqueline DiChiara

The ongoing payment transition from volume to value is bringing the concept of forced alignment into the spotlight. Hospitals, unsure what new outpatient services are best to implement, are now focused on making effective choices. Are such choices focused...

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