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

Latest RCM News News

Groups Question Changes to Medicare Shared Savings Program

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118 out of 220 participating Medicare Shared Savings Program ACOs generated savings through reduced costs, but only 58 of these ACOs managed to meet the shared savings threshold. Seventeen medical organizations which includes the American College...

AHA Reacts to Proposed Rule for Medicare Shared Savings Program

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CMS’s proposed changes to the Medicare Shared Savings Program would save approximately $280 million more than the median net savings in federal funds from 2016 through 2018. The Medicare Shared Savings Program (MSSP) seeks to save money...

Medicare Overpays Hospital $414,000 for Incorrect Medical Billing

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The Hospital did not fully comply with Medicare requirements resulting in approximately $414,000 in overpayments for incorrect medical billing. The Department of Health and Human Service (HHS) Office of Inspector General (OIG) released the results...

Hospitals Oppose Further Medicare and Medicaid Cuts

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The AHA and other hospital groups wrote a letter to Congress, encouraging them to avoid  Medicare and Medicaid cuts following the repeal of the SGR. The Medicare Sustainable Growth Rate (SGR) has long been a thorn in healthcare’s...

How the 2016 Budget Will Change Medicare and Medicaid

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2016 Budget plans will have both improvements and challenges for  Medicare and Medicaid providers. On Monday, February 2, 2015, President Barack Obama released the 2016 Federal budget. It reveals plans for saving federal money on Medicaid...

Medicare and Medicaid Cuts One of Many Revenue Problems

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Medicare and Medicaid pay less for services rendered than private insurance. The Medicaid “fee bump” instated by the Affordable Care Act (ACA) temporarily increased the reimbursement rates for doctors who accepted Medicaid patients....

KLAS Study Examines Revenue Cycle Management Vendors

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Revenue Cycle Management solutions are impacting healthcare practices and trusted vendors are starting to emerge. KLAS is a global research firm that specialized in improving healthcare delivery. This month, it released a study of healthcare...

CMS Proposes Change to Home Health Agencies CoP

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On Thursday, October 9, 2014, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that would revise the current conditions of participation (CoPs) that home health agencies (HHAs) are required to meet in order to...

HHS awards $295M in funding for better primary care access

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Last week, $295 million in Affordable Care Act funding was awarded to 1,195 health centers in every state, the District of Columbia, Puerto Rico, the US Virgin Islands and the Pacific Basin to expand primary care services. The Department of Health...

Research finds higher Medicare spending in unhealthy states

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Socioeconomic factors that affect the need for medical care, along with interactions between the Medicare system and other parts of the health system are main reasons why there is variation in Medicare health spending between states, according...

CMS falls behind on regulating rural health clinics

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The Centers for Medicare & Medicaid Services (CMS) has not issued final regulations to a portion of Rural Health Clinics (RHCs) that would enable those facilities to be considered an essential healthcare provider, according to a recent report...

Are health insurance exchanges the way of the future?

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Retail organizations faced with increasing healthcare costs and regulatory demands are increasingly looking toward health insurance marketplaces – also known as exchanges – when it comes to their employees’ coverage options, according to...

Does Vermont have the least expensive healthcare costs?

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Vermont residents could be paving the way for the rest of the nation in terms of healthcare spending patterns, as a recent report found that those living in the Green Mountain State spent fewer dollars on healthcare between 2007 and 2011. However,...

Kansas Medicaid experiences $72 million setback

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The three insurers administering Kansas Medicaid coverage lost $72.6 million in the first half of 2014. This is just the next step in a downward trend, as the KanCare system lost $110 million in 2013. “These companies can’t keep subsidizing...

Texas Workforce Commission claims $15 million in CCDF funds

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The Texas Workforce Commission did not comply with federal requirements for the use of approximately $15 million in the Child Care and Development Fund (CCDF) targeted funds for fiscal year 2010, according to a recent audit by the Department...

OIG: La. overpaid $1.8 million in meaningful use incentives

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The Louisiana Department of Health & Hospitals was one of the first state organizations to pay EHR incentive payments. In fact, Louisiana made approximately $93 million in Medicaid EHR Incentive Program payments during the 2011 calendar year,...

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