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

Latest RCM News News

CMS Touts Progress of State-Led Alternative Payment Model


States participating in the first phase of the State Innovation Model Initiative have made significant progress in implementing alternative payment models, CMS officials revealed midweek. Two of six states were able to link more than half of...

CMS: Medicare Accountable Care Organizations Saved Over $466M


Medicare accountable care organizations (ACOs) saved more than $466 million in 2015, with 125 ACOs qualifying for shared savings payments under the value-based care model, CMS reported in an announcement earlier this week. “The coordinated,...

CMS Paid $1.47B to Settle Medicare Reimbursement Disputes


CMS paid nearly $1.47 billion to healthcare providers last year to settle Medicare reimbursement disputes, according to data recently released by the federal agency. The settlements were distributed to 2,022 hospitals to end the appeals process...

HHS Awards $100M to Health Centers for Quality Improvement


The Department of Health and Human Services recently granted over $100 million in awards to 1,304 health centers across the nation to help improve care quality and boost primary care services, according to the federal department’s website....

AHIMA Proposes Revisions to New Group of ICD-10-PCS Codes


Six months after the healthcare industry managed to make its initial transition to ICD-10 with few significant issues, CMS is planning to lift its freeze on the addition of new codes. Approximately 5000 new codes will join the existing ICD-10-CM...

CMS Extends Deadline for Bundled Payment Models Participation


The federal government especially the Centers for Medicare & Medicaid Services (CMS) have long focused on reducing healthcare spending and implementing alternative payment models such as pay-for-performance initiatives. Bundled payment models,...

Medicare Shared Savings Grows Among Burgeoning Payment Models


Since the healthcare industry has experienced rising costs over the years, providers and federal agencies have focused their energies on implementing new value-based payment models and healthcare delivery systems like accountable care organizations...

HIMSS: Providers Not Ready for Value-Based Care Reimbursement


In recent years, the healthcare industry and the revenue cycle of providers has had a much greater target of achieving value-based care reimbursement and moving away from fee-for-service payment systems. The Centers for Medicare & Medicaid...

Affordable Care Act Saved Medicare Beneficiaries $20 Billion


The Affordable Care Act (ACA) has saved over 10 million Medicare beneficiaries upwards of $20 billion on prescription drugs over the past six years, according to new information from the Centers for Medicare & Medicaid Services (CMS). Millions...

KLAS Research Assesses Providers’ Value-Based Care Focus


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...

3 Strategies to Innovatively Advance Emergency Care Delivery


The simple concept of value is a missing piece of the emergency department (ED) care spectrum puzzle, according to key findings released within Press Ganey’s white paper survey of over 1 million patients. Through the execution of numerous...

GAO Announces New Physician-Payment Model Advisory Committee


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...

HHS Announces $685M Awards in Patient-Centered Clinician Aid


The Department of Health and Human Services (HHS) is on a mission to improve the quality of healthcare, advance patients’ information accessibility, and decrease expenses across the industry. According to today’s announcement from...

Summary of CMS’s Top 5 Proposed Payment Rules, Revisions


The Centers for Medicare & Medicaid Services (CMS) has continuously released a steady stream of payment policies and physician fee schedules. As reported in a summary of top 6 previously proposed payment rules and...

No Medicare Claim Denials After ICD-10 Transition, Says CMS


ICD-10 implementation is now a horse of a different color. The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) are seeing eye-to-eye on matters of ICD-10 and claims denial. CMS has outlined 4...

CMS Announces HPID Final Rule Public Commentary Period


The Department of Health and Human Services (HHS) released a Request for Information (RFI) earlier this month on the Health Plan Identifier (HPID). HPID – a standard identifier for health plans – is required to be adopted under the...

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


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...

AMA Inaugurates Stack, Youngest President in 160 Year History


Steven J. Stack, MD, has been sworn in as the youngest president of the American Medical Association (AMA) within the past 160 years. Stack is the 170th president of the AMA, the nation’s largest physician organization. "I am...

CMS: Successful April Medicare FFS ICD-10 End-to-End Testing


According to today's announcement from the Centers for Medicare & Medicaid Services (CMS), ICD-10 implementation success is here. Between Monday, April 27 and Friday, May 1, Medicare Fee-For-Service (FFS) healthcare providers, clearinghouses,...

New House Bill Requires ICD-10 Transition Period Testing


The House of Representatives has introduced a new bill, H.R. 2247, requesting a mandatory ICD-10 transition period following the October 1, 2015 ICD-10 implementation date. This bill – the Increasing Clarity for Doctors by Transitioning...


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