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

Latest RCM News News

CMS Promotes ICD-10 Readiness with More End-to-End Testing

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There are 142 days left until the International Classification of Diseases – ICD-10 – compliance. What’s next? More Medicare end-to-end testing efforts, says The Centers for Medicare & Medicaid Services (CMS). CMS has announced...

AHA Announces New President and CEO, Rick Pollack

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Rick Pollack will be the next President and Chief Executive Officer of the American Hospital Association (AHA), announces AHA’s Board of Trustees. This September, Pollack will formally replace Richard J. Umbdenstock. Umbdenstock is...

Bipartisan House Repeals Medicare SGR Before Senate Vote

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There are possible new improvements to the Medicare Sustainable Growth Rate (SGR) payment system today as the bipartisan House of Representatives overwhelmingly passed the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2). This legislation...

Hospital Claims $173,000 in Medicare Overpayments

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Hospital did not fully comply with Medicare requirements for billing inpatient and outpatient services. The Department of Health and Human Service (HHS) Office of Inspector General (OIG) released the results of its audit on Utah Valley Regional...

Medicaid Expansion in Nebraska and Kansas

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With 29 states and DC having already opted to expand their Medicaid coverage, other states are aiming to join the trend. The decision to expand Medicaid continues to be a legal struggle for many states. The decision could substantially...

Pennsylvania Plans for Medicaid Expansion

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The Medicaid expansion is 100 percent federally funded for the years 2014 through 2016. On February 9, 2015, Governor of Pennsylvania, Tom Wolf announced that the State would be transitioning to a Medicaid expansion plan. This plan will replace...

Wyoming Rejects Medicaid Expansion with 19-11 Vote

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Following the negative feedback on the Budget, the bill was rejected with a 19-11 vote and a parallel Medicaid expansion bill was pulled. According to an article by Ruffin Prevost on Reuters, on February 6, 2015, the Wyoming Senate rejected a...

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,...

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