Sponsored by Zelis
Electronic Payment Key to Streamlining Healthcare Claims Management
The complexity around healthcare claims management is a major pain point for provider organizations, big and small. The increasing cost of claims coupled with a complex system of many payers, each with...Sponsored by Zelis
Why Claims Payment Optimization is Crucial for Providers
Claim payment is one of the most important steps in the claims management process. Healthcare providers rely on this step to keep their operations running smoothly for patients. But while claim payment...40% of Charges for COVID-19 Services Initially Ended in Claim Denials
Providers are having a difficult time billing for services related to COVID-19, with 40 precent of charges for coronavirus-related care initially winding up as claim denials in the first 10 months of...Prior Authorizations Beat COVID Workplace as Top Regulatory Burden
Prior authorizations are troubling medical groups more than regulations governing the workplace during COVID-19 and Medicare’s Quality Payment Program, according to survey results from the...AHA Calls for Medicare Advantage Inclusion in Prior Authorization Rule
The American Hospital Association (AHA) has asked CMS to include Medicare Advantage organizations in its proposed rule that would streamline the prior authorization process and reduce patient care...HHS Removes 79% of Medicare Appeals Backlog, On Track for FY 2022
HHS has reduced the Medicare appeals backlog at the Administrative Judge Level by 79 percent, which puts the department on track to clear the backlog by the end of the 2022 fiscal year. As of June 30,...Difference Between Clean Claims, Initial Claim Denials Key Hospital KPI
The difference between clean claims and initial claims denials is a major key performance indicator (KPI) that hospitals track, according to a new survey. The new survey from healthcare revenue cycle...Physician Practice Interruption Increased Due to COVID-19 Pandemic
Physician practice interruptions, like declining patient volumes and claims submitted, were abundant in 2020 compared to the previous year, likely due to the COVID-19 pandemic, according to research...How Nebraska Medicine Turns Claims Data into Revenue Cycle Strategy
Healthcare providers and payers send millions of business transactions a day. These transactions ensure providers get paid for delivering care to patients, but they also create a treasure trove of data...Telehealth Claim Lines Stabilize After Months of Decline
The percentage of telehealth claim lines has stabilized at about 5 percent of medical claim lines, indicating a new balance of virtual and in-person care. The analysis conducted by FAIR Health as part...AMA Calls for Suspension of Prior Auths During PHEs, Better Peer Reviews
Payers should temporarily suspend prior authorization requirements during public health emergencies (PHEs), according to a new policy from the American Medical Association (AMA). Physicians have faced...Over Third of Hospital Execs Report Claim Denial Rates Nearing 10%
Hospital claim denial rates are at an all-time high, signaling a need for better claims denial management, a recent survey from Harmony Healthcare reveals. The healthcare industry has seen a 20 percent...Medicare Claims Data Show Health Disparities in COVID-19 Patients
Researchers found significant disparities in Medicare fee-for-service beneficiary spending in an analysis of Medicare claims data relating to COVID-19, according to a Centers for Disease Control and...CT Physicians Accused of “Price Gouging” COVID-19 Tests
A group of physician practices in Connecticut suing Cigna over COVID-19 reimbursement is actually exploiting a national health emergency by overcharging for COVID-19 tests, the payer recently told a...Sponsored by Ontario Systems