Sponsored by Brault
Preventing Medical Necessity Denials With Clinical Documentation
Healthcare coverage has never been more important, one of the many lessons we’ve learned during the COVID-19 pandemic. And private insurance companies have reaped the benefit of this growing need...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...Hospital Revenue Cycle Transformation Needed to Boost Performance
Hospital revenue cycle transformation is needed to elevate poor enterprise performance as a result of the COVID-19 pandemic, experts from healthcare management consulting firm Kaufman Hall reveal in a...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...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...Sponsored by Experian Health
Key Ways Patient Identity Management Boosts the Bottom Line
Inaccurate and incomplete patient information poses obvious safety risks—patients can be injured, even fatally, if clinicians mix up their identities. But patient identity management can also...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...RCM Automation Boosts Practice’s Accounts Receivable Efficiency
Days in accounts receivable (A/R) is one of the most important key performance indicators for growing practices. In an increasingly complex healthcare environment—and one in which financial...Top Challenges, Opportunities of Medical Coding and Billing
By April of last year, seemingly every news station in American was featuring the heroic efforts of physicians, nurses, and other clinicians fighting COVID-19. These providers transformed healthcare, implementing telehealth and virtual...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 Claim Denials Up for Most, Driven by Prior Authorizations
Hospitals and health systems are facing a growing volume of claim denials, with private plan prior authorization issues driving the recent increase, according to a new report from the American Hospital...Sponsored by XIFIN
Key COVID-19 Claim Denial Trends Arising from the CARES Act
The Coronavirus Aid, Relief, and Economic Security (CARES) Act was developed to provide the healthcare resources needed to fight COVID-19. Signed into law March 27, 2020, the Act was designed to...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...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
Gain New Insights With Analytics, AI to Accelerate RCM Workflow
Today’s healthcare leaders face more challenges than ever ― from increasing claim volumes to more rigorous payor requirements and more demanding reporting obligations. As a result,...Sponsored by 3M
