Claim Automation Up, But $16.3B Remains in Potential Savings
Levels of claim automation have risen in healthcare over the past year, but so has the opportunity for further savings through technology, the Council for Affordable Quality Healthcare, Inc. (CAQH)...Hospital Claim Denials Steadily Rising, Increasing 23% in 2020
Hospitals are receiving more claim denials from payers, with the average rate increasing by 23 percent in 2020 compared to four years ago, according to a recent analysis. The hospital claim denial...Hospital Uncompensated Care Costs Grew to $41.61B in 2019
Hospital uncompensated care costs increased right before the COVID-19 pandemic hit, according to new data from the American Hospital Association (AHA). AHA data showed that hospitals incurred a new...AMA Creates CPT Codes for AstraZeneca’s COVID-19 Vaccine
In anticipation of an emergency use authorization from the Food and Drug Administration (FDA), the American Medical Association (AMA) has created Current Procedural Terminology (CPT) codes for...Year in Review: Most Read Revenue Cycle Management Stories of 2020
2020 will go down in history as one of the most challenging years for healthcare providers. From battling a pandemic caused by a novel virus to halting all non-emergent services at the expense of the...Key Considerations for COVID-19 Vaccine Billing and Coding
For many providers, the end of the pandemic is in sight with the recent emergency use authorization of a COVID-19 vaccine. And while this may be true, it is just the start of a COVID-19 vaccine billing...New ICD-10 Codes, MS-DRG Assignments for COVID-19 Coming Jan. 1
Come January 1, 2021, CMS will implement 21 new ICD-10 procedure codes for COVID-19 vaccines and therapeutics for the novel coronavirus, including baricitinib and monoclonal antibody treatments. The...Telehealth Billing Leveled Out in August, But Still Up 3,552%
Providers are still treating a significant number of patients virtually or by phone, but telehealth billing has plateaued compared to earlier this year, according to updated data from FAIR...AMA Introduces CPT Code to Account for COVID-19 Safety Protocols
Shortly after releasing the 2021 Current Procedural Terminology (CPT) code set, the American Medical Association (AMA) added two more codes related to COVID-19, including one that accounts for the...Providers Confused by COVID-19 Coding, Claim Requirements
Erratic claim volumes and confusion over COVID-19 coding and claim requirements are the top issues impacting revenue cycle operations, according to a new survey of financial leaders at US hospitals and...AMA Announces New CPT Codes for Coronavirus Testing
The American Medical Association (AMA) recently expanded its Current Procedural Terminology (CPT) code set to include four new CPT codes for coronavirus testing, according to a special coding guidance...Medical Billing Mistakes for Malnutrition Led to $1B in Overpayments
CMS should recoup the portion of nearly $1 billion that was incorrectly paid to hospitals because of medical billing and coding errors involving severe malnutrition diagnosis codes, HHS’ Office...Telehealth Billing Increased 8,336% from April 2019 to April 2020
Telehealth billing continued to surge amid the COVID-19 pandemic, with telehealth claim lines increasing by 8,336 percent in April 2020, according to a new FAIR Health data. New data from FAIR...HHS Reduces Medicare Appeals Backlog by 43%
The latest Medicare appeals backlog status report, acquired by the American Hospital Association (AHA), shows a 43 percent reduction in the number of pending appeals at the Administrative Law Judge...Prior Authorization Burden Continues to Rise, Physicians Report
Physicians are still expending a significant amount of time and resources on prior authorizations as the burden of the process continues to increase, according to a recent survey conducted by the...Mending Payer Relations Smooths Revenue Cycle at Northwestern Med
Payers and providers have existed on different sides of the same fence, meeting in the middle once or twice a year to negotiate contracts or resolve major issues. However, technology, revenue cycle...Sponsored by Experian Health
3 Key Activities to Prevent Denied Claims in 2020
Despite relentless efforts to curb the growth in denied healthcare claims, physician practices see between five and ten percent of claims continue to be rejected by commercial and public payers each...Sponsored by XIFIN
Clean Claim, Write-Off Metrics Key to Diagnostic Provider Success
Diagnostic provider leadership teams understand the importance of revenue cycle management (RCM) for maximizing reimbursement promptly. Submitting clean claims is one of the most important ways that a...Sponsored by 3M
