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

Reimbursement News

Top 7 New Strategies for Revenue Cycle Management Excellence


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


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


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


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


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


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....

Low Reimbursement, High Costs Threaten Physician RCM Success


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...

How Does Meaningful Use Impact Revenue Cycle Management?


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...

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...

Why Focusing on Hospital Readmission Causes Is Essential


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...

Performance-Based Pay Hot as Healthcare Exec Salaries Rise


Median base healthcare salaries are on the up and up, according to recently released results within a 2015 executive healthcare and hospital compensation survey press release from Sullivan, Cotter and Associates. Data collected from...

How to Achieve Value Within the Value-Based Care Transition


The Department of Health and Human Services (HHS) is on a mission to associate 90 percent of Medicare payments to value within the next three years and Congressional passage of the Medicare Access and CHIP Reauthorization Act of 2015...

Survey Shows Payment, Workflow of Private Health Practices


Private practices and traditional, fee-for-service provider facilities are two primary operational models in the healthcare industry. While either practice model has its own unique benefits, it is clear that their payment models are quite different....

3 Strategies to Improve Healthcare Supply Chain Management


The evolution and progression of supply chain and reimbursement tactics and procedures within the healthcare industry serves as a keen focal point requiring acute attention to detail if success is to be met. The following is a compilation of...

How to Rescue Revenue Cycle with Medicare Appeals Pending


The rehabilitation needs of Medicare beneficiaries within the state of California may be in jeopardy. Payment for hundreds of thousands of claims for services is being denied. Most of these denials are reportedly invalid, confirms past appeal...

HHS Urged to Resolve Pending Medicare Appeals in Filed Suit


Casa Colina Hospital and Centers for Healthcare recently filed suit to require timely Medicare patient care appeals mandated under federal law.  The Medicare program is denying payment for hundreds of thousands of claims for services....

Are the Cheapest Provider-Owned Health Plans More Expensive?


The demise of the fee-for-service model may be unsuccessful in producing the most economically efficient health plans, confirms a new study from HealthPocket. Demonstrating significant findings that are simply “contrary to expectations,”...

Unreliable Health Plan Provider Directories Burden Providers


Under the establishment of the Affordable Care Act (ACA), millions of people have enrolled in new health insurance plans via the health insurance marketplace. When signing up for these new plans, consumers rely on information provided to them...

Is the ACA Working as Intended to Improve Healthcare Access?


Is the Affordable Care Act (ACA) living up to its full potential or is it more a matter of all healthcare hands on deck? In past interviews with, healthcare experts and leaders from both athenahealth and the Robert...

Value-Based Payment Preparation Requires Cost Measurement


Value-based payments present numerous challenges to healthcare providers. Healthcare finance departments may have a bit of catching up to do. Following an announcement from the Centers for Medicare & Medicaid Services regarding an actively...


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