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

Medical Billing

Hospitals, Systems Spend $39B Annually on Regulatory Compliance

October 31, 2017 - Hospitals, health systems, and post-acute care providers spend almost $39 billion annually on administrative tasks related to regulatory compliance, the American Hospital Association (AHA) reported. “As a result of this extraordinary burden, providers are struggling to balance the administrative activities necessary to comply with regulatory requirements against the clinical, operational...


More Articles

77% of Leaders Say Their Provider Orgs Use Paper Patient Billing

by Jacqueline Belliveau

While over one-half (52 percent) of patients prefer to receive medical bills electronically, approximately 77 percent of providers still use paper-based patient billing methods, a recent MGMA and Navicure survey revealed. The survey of 761 executives...

OK Physician Pays $580K to Settle Medicare Fraud Allegations

by Jacqueline Belliveau

A physician from Oklahoma recently agreed to pay $580,000 to settle a Medicare fraud case in which the federal government alleged that he submitted false claims to the federal healthcare program, the  Department of Justice (DoJ) announced....

36% of Providers Never Address Patient Financial Responsibility

by Jacqueline Belliveau

Healthcare organizations are struggling to collect full patient financial responsibility, especially with the rise of high-deductible health plans. Yet, 36 percent of providers report never discussing a patient’s ability to pay prior to...

New Medicare Fraud Audits to Ease Burden on Compliant Providers

by Jacqueline Belliveau

CMS recently updated its Medicare fraud and improper payment audit process to target providers and suppliers who continually demonstrate high medical billing error rates, according to the federal agency’s website. The new Targeted Probe...

68% of Consumers Did Not Pay Patient Financial Responsibility

by Jacqueline Belliveau

About 68 percent of patients with medical bills of $500 or less did not fully pay their patient financial responsibility to hospitals in 2016, according to a recent TransUnion Health study. The proportion of individuals failing to pay off full...

Top 4 Patient Financial Responsibility Collection Methods

by Jacqueline Belliveau

The top priority for providers is to deliver high-quality healthcare services to their patients. But the recent rise in patient financial responsibility and healthcare consumerism has forced some providers to bump patient collections to the top...

2016 Medicaid, Medicare Improper Payments Over Regulatory Cap

by Jacqueline Belliveau

A recent Office of the Inspector General (OIG) report revealed that the rates of Medicaid and Medicare improper payments in 2016 exceeded the legislative threshold of less than 10 percent. The improper payment rate for Medicare fee-for-service...

Third MI Provider Convicted in $17.1M Healthcare Fraud Case

by Jacqueline Belliveau

Healthcare fraud prevention and prosecution will continue to be a major area of focus for the Department of Justice (DoJ), Acting Assistant Attorney General Kenneth A. Blanco recently told the American Bar Association. With healthcare fraud draining...

Is Billing Some Patients at Hospital Chargemaster Rates Legal?

by Jacqueline Belliveau

Contract law does not uphold the medical billing practice of charging uninsured or out-of-network insured patients hospital chargemaster rates that are not based on actual healthcare costs or market-negotiated prices, argued authors of a recent...

Patient Financial Responsibility Not Owed Top Medical Debt Issue

by Jacqueline Belliveau

A recent report from the think tank Frontier Group and the US Public Interest Research Group (PIRG) Education Fund may spell trouble for providers attempting to collect overdue patient financial responsibility either internally or through a debt...

Credit Card On File Program Key To Patient Collections Success

by Jacqueline Belliveau

Implementing a credit card on file program boosted patient collections and reduced accounts receivable by 28 percent in six months at Orthopaedics & Rheumatology of the North Shore, a four-physician specialty practice in Illinois. Consumers...

28% of Adults Say Docs Discuss Patient Financial Responsibility

by Jacqueline Belliveau

Patients are still trying to figure out and compare healthcare prices, a recent Public Agenda survey showed. Yet only about 28 percent of the over 2,000 adults Americans surveyed said that their provider or their staff have discussed patient...

Preparing Providers for the Healthcare Consumerism Shift

by Jacqueline Belliveau

With a couple of swipes and clicks, patients are driving the shift to healthcare consumerism in the palm of their hands. But many healthcare organizations are not finding it as easy to align their care delivery and patient collection strategies...

Only 20% of Providers Offer Card-On-File Patient Collections

by Jacqueline Belliveau

Even though patient financial responsibility continues to grow, a recent Navicure survey showed that many healthcare organizations are not meeting patient collection needs, such as electronic payments. Th survey of providers and patients from...

GA Dentist Sentenced to Prison for $1M Medicaid Fraud Scheme

by Jacqueline Belliveau

A dentist from Georgia faces one and a half years in federal prison after she reportedly participated in a Medicaid fraud scheme totaling almost $1 million, the Department of Justice (DoJ) recently announced. From 2009 to 2013, Oluwatoyin Solarin,...

4 Key Ways to Boost Point-of-Service Patient Collections

by Jacqueline Belliveau

In a time of healthcare consumerism and high-deductible health plans, the patient has become a major revenue source for healthcare organizations. But without strong point-of-service patient collection strategies, providers could be seeing their...

OIG: NJ Agency Falsely Claimed $95M in Medicaid Reimbursement

by Jacqueline Belliveau

New Jersey’s Department of Health and Human Services may have to repay the federal government almost $95 million after the Office of the Inspector General (OIG) recently found that the state agency received improper Medicaid reimbursement...

Unexpected Patient Financial Responsibility in 20% of ED Cases

by Jacqueline Belliveau

Approximately 20 percent of hospital admissions stemming from an emergency department visit in 2014 led to unexpected patient financial responsibility in the form of surprise medical bills, a recent Health Affairs study reported. Using national...

How a Small Hospital Increased Patient Collections by 300%

by Jacqueline Belliveau

As patient financial responsibility continues to increase in a more consumer-focused healthcare environment, more hospitals are shifting healthcare revenue cycle management strategies to improve patient collections. Iroquois Memorial Hospital...

Continue to site...