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

Healthcare Providers

Addressing Hospital Executives’ Supply Chain Management Gaps

by Jacqueline DiChiara

Healthcare supply chain transparency may save billions of dollars in waste by strengthening financial performance and enhancing the quality of value delivered. The quite simple need for more money never really dies within the...

4,000 Healthcare Providers Receive $54M for HEDIS Excellence

by Jacqueline DiChiara

Physicians are demonstrating their continued dedication to advancing the quality of healthcare and helping Medicare Advantage members receive optimum treatment and are getting paid accordingly for doing so. UnitedHealthcare recently...

CMS Answers ICD-10 FAQs for Healthcare Providers

by Sara Heath

ICD-10 implementation will begin on October 1, 2015, and as such, the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) announced that, in order to ease the transition, they will be flexible when...

Healthcare Providers Await Slashed Revenue Following ICD-10

by Jacqueline DiChiara

Will ICD-10 implementation on October 1 kick off as a dynamic bang or a lackluster bust? Most healthcare providers are optimistic when it comes to ICD-10 reimbursement and workflow expectations, according to results from a recently...

Value-Based Payment Preparation Requires Cost Measurement

by Jacqueline DiChiara

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...

CMS: Successful April Medicare FFS ICD-10 End-to-End Testing

by Jacqueline DiChiara

According to today's announcement from the Centers for Medicare & Medicaid Services (CMS), ICD-10 implementation success is here. Between Monday, April 27 and Friday, May 1, Medicare Fee-For-Service (FFS) healthcare providers,...

Streamlined Core Measures Advance Cost-Effective Healthcare

by Jacqueline DiChiara

Improved health at lower cost means paying special attention to magnified metrics. This task is no simple feat. Although there are currently thousands of possible core measures providing healthcare professionals, payers, policy makers, and...

Top Six Proposed Physician Fee Schedules, Payment Policies

by Jacqueline DiChiara

The healthcare industry awaits the possibility of great financial policy adjustment in the immediate future due to a continuous stream of announcements from The Centers for Medicare & Medicaid Services (CMS) regarding various proposed...

ICD-10 Implementation: Five Facts to Know Now

by Jacqueline DiChiara

Many commonly accepted myths have been recently circulating among healthcare providers, payers, and professionals about the upcoming implementation of ICD-10, the tenth revision of the International Classification of Diseases. Some...

MACRA Fee Adjustments May Generate Financial Consequence

by Jacqueline DiChiara

Physicians and healthcare providers may endure an even greater financial consequence under the $200 billion Medicare reform package signed by President Obama last week, H.R. 2, the Medicare Access and CHIP Reauthorization Act (MACRA) than...

Electronic Transactions Could Save Healthcare Billions  

by Jacqueline DiChiara

As the healthcare industry continuously eliminates paper-based administrative processes and pushes for mainstream electronic transactions, the possible result is essentially tens of billions in savings for the healthcare industry. If six...

Summary of Health Insurance Marketplace Final Rule for 2016

by Jacqueline DiChiara

CMS issued a 476-page final rule to promote improving the overall Health Insurance Marketplace consumer experience by ensuring affordable and accessible coverage options. On February 20, the federal agency released the final rule, Notice...

Medicare and Medicaid Cuts One of Many Revenue Problems

by Stephanie Reardon

Medicare and Medicaid pay less for services rendered than private insurance. The Medicaid “fee bump” instated by the Affordable Care Act (ACA) temporarily increased the reimbursement rates for doctors who accepted Medicaid...

California Nurses Fight for Increased Quality of Care, Reimbursement

by Stephanie Reardon

CNA seeks to increase pay for registered nurses and nurse practitioners by 14 percent over the next three years. A two-day nursing strike scheduled for January 21 and 22, 2015 has been cancelled after nurses in Northern and Central...

Quincy Medical Closes after Cuts to Medicare, Patient Volume

by Jennifer Bresnick

Declining patient volumes and inadequate reimbursement have led to the closure of Quincy Medical Center in Massachusetts. Quincy Medical Center, which serves patients in the Greater Boston area, will shut down its inpatient services on...

4.1% Jump in Hospital Admissions Brings Extra Revenue to HCA

by Jennifer Bresnick

Higher utilization of healthcare services has brought an earnings bump to Hospital Corporation of America. A significant jump in the number of hospital admissions helped to bump up reported revenue during the third quarter for Hospital...

How High Performing Practices Focus on Revenue Cycle Management

by Jennifer Bresnick

High performers put revenue cycle management and patient satisfaction at the core of their operational improvement programs. The highest performing practices focus on four key areas of revenue cycle management, MGMA notes in a new study,...

Revenue Drops 26% at Texas Presbyterian in Wake of Ebola

by Jennifer Bresnick

Texas Health Presbyterian has taken a huge revenue hit after questionable handling of three Ebola cases this month. In a sharp lesson on the importance of reputation for hospitals nationwide, Texas Health Presbyterian Dallas has seen its...

Emerging Managed Care Pharmacy Trends Impact Patients, Payers

by Ryan Mcaskill

On October 9, the Academy of Managed Care Pharmacy (AMCP) Foundation released a new study that examines emerging trends in the shifting health care market. The “Ahead of the Curve: Top 10 Emerging Health Care Trends –...

Pentagon Slashes Autism Healthcare Payments

by Elizabeth Snell

Impending policy changes around TRICARE, a healthcare program for the military and their dependents, have many individuals concerned over how autism therapy coverage will be handled. The Pentagon announced planned healthcare payment...

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