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

Reimbursement News

What Are the Greatest Revenue Cycle Management Challenges?

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RevCycleIntelligence.com recently polled over 60 readers to assess revenue cycle management challenges and opportunities, from the front-end, to the back-end, and everything in between. Readers said collecting payment from a patient in a timely...

4 HIMSS16 Revenue Cycle Management, Value-Based Care Focuses

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The topics of revenue cycle management innovation and value-based care will be of key importance at HIMSS16, one of the largest healthcare information technology (IT) conferences of the year, held next month in Las Vegas. Promoting financial...

CMS Final Rule Revises Medicaid Reimbursement, Drug Rebates

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Medicaid reimbursement improvements are underway, according to a final rule from the Centers for Medicare & Medicaid Services (CMS). The rule – CMS-2345-FC – provides greater detail about Medicaid reimbursement and rebate calculation....

Why Flawed Alternative Payment Model Design Holds MACRA Back

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Alternative Payment Models (APMs) do not adequately address payment system problems, according to a new report from the Center for Healthcare Quality and Payment Reform (CHQPR). Healthcare payment reform is apparently progressing at a snail’s...

Value-Based Care Models Still Pose Opportunities, Challenges

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The value-based care model is allegedly winning the claims reimbursement race, leaving its fee-for-service competitor in the dust. How valid is the widespread claim that value-based reimbursement models are tied to higher care quality levels,...

High Patient Experience Ratings Up Revenue Cycle Management

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Positive patient experience ratings generate a healthy and happy revenue cycle management, according to Press Ganey’s new white paper. But healthcare payment reform challenges may be keeping providers from seeing more revenue...

Providers Face Value-Based Care’s Financial Reality, Demand

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The value-based care transition is a sizable endeavor for healthcare providers. Jumping in head first into dark payment water takes bravery, experience, and knowledge. Although healthcare leaders are often hesitant to fully commit to...

4 Value-Based Care Models Demanding New Long-Term Focus

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Value-based care models are taking over the healthcare industry. Providers are struggling to stay ahead of the reimbursement curve, some smiling more than others when they consider where their ROI currently sits. The transition away from...

HHS, CMS Speak Out on CMS’s Innovation Center Pilot Project

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Medicare reimbursements are preparing to emerge from a fee-for-service caterpillar’s cocoon to a value-based butterfly. The newly announced Accountable Health Communities [AHC] model – a CMS Innovation Center Pilot...

3 Snags of Expensive Affordable Care Act Deductibles, Copays

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Money woes stemming from expensive Affordable Care Act (ACA) exchange policies may be hindering communication efforts between physicians and patients. Costly deductibles and copays mean patients may be more commonly skipping chats about drug...

A Very Happy New Year from RevCycleIntelligence.com!

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2015 was The Year of ICD-10. News of grace period delays, deadline extensions, claims management woes, and discussions about a proposed freeze topped our most popular articles of the year. “The long-awaited U.S. transition to...

3 Hard Reimbursement Questions Physicians Are Afraid to Ask

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Physicians sought answers to many pressing reimbursement questions this year. 2015 saw heightened anticipation of reimbursement delay and claims denials once ICD-10 kicked into gear, ongoing discussion among physicians nationwide about how a...

5 Claims Reimbursement Questions and Answers

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Money talks and the healthcare industry is listening. Claims reimbursement was one of many weighty revenue cycle management topics the healthcare industry kept an ear out for this year. From the art of claims scrubbing to figuring out how to...

Hospitals Facing More Payment Claims Audits, Costly Denials

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Hospitals are allegedly trying to do the best they can, even when money is slow to come in. Nearly half of all Recovery Audit Contractor claim denials are denied by hospitals, according to a new report from the American Hospital Association (AHA)....

Top 7 New Strategies for Revenue Cycle Management Excellence

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Money may be the root of all evil, but it is also the root of the healthcare industry. Revenue cycle management, based upon the straightforward notion of continuously staying in the black, is about getting paid, and expediently so. Within the...

Top 6 Trending Payment Models Demanding New Long-Term Focus

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Time is money, especially when it comes to healthcare. Paying for outcomes gained instead of mere services rendered is the new name of the healthcare game. This means the simple notion of paying for multiple physician visits, medical...

Why Value-Based Care Yields Lower Cost, Higher Quality Care

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Value-based care is in the lead compared to its fee-for-service competitor, according to Humana’s new Medicare Advantage population health results. “Members treated under the care of providers in value-based reimbursement models with...

Top 4 Strategies to Achieve Affordable Value-Based Care

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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...

Pew Urges CMS to Consider Physician-Focused Payment Models

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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...

Humana Pays Physician Groups $77M for Value-Based Outcomes

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As the fee-for-service realm dissipates and the value-based reimbursement model nears its completed transition in coming years, Humana is granting sizable financial rewards for those physician groups yielding quality care outcomes....

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