Auditors Recouped $214M in Medicare Improper Payments in 2016
Recovery Audit Contractors (RACs) returned significantly more Medicare improper payments to the program’s trust fund during the 2016 fiscal year (FY), a recent CMS report to Congress shows. In...Medicare Advantage Plans Overturn 75% of Their Own Claim Denials
A new report from the HHS Office of the Inspector General (OIG) reveals “widespread and persistent problems” related to prior authorization and claim denials in Medicare Advantage. Using...Clinical Documentation Improvement Solutions Up Provider Revenue
Provider organizations are seeing financial improvements after implementing clinical documentation improvement (CDI) solutions, a recent KLAS survey shows. Revenue improved for about 53 percent of...AMA, AHIP, and Others Oppose Upside-Only ACO Changes for MSSP
The American Medical Association (AMA), Medical Group Management Association (MGMA), and Health Care Transformation Task Force (HCTTF) are among nine industry groups calling on CMS to reconsider...End-to-End Revenue Cycle Management Key to Success at Ascension
The healthcare revenue cycle contains many moving parts. Hospitals and health systems typically rely on a patchwork of technologies and best practices to ensure everything from patient access and...Sponsored by symplr
States Look to Streamline Payer Enrollment, Cut Provider Paperwork
Healthcare is a waiting game, with the most common example being the patient waiting room. But patients aren’t the only healthcare stakeholders left waiting. Healthcare organizations oftentimes...Sponsored by symplr
How Automating Payer Enrollment Reduces Time to Reimbursement
Manual claims management processes significantly slow down time to reimbursement. However, payer enrollment services can help healthcare organizations digitize the key claims management step to reduce...MSSP ACOs Saved $1.84B, Nearly Double CMS Estimate, Study Finds
CMS estimates that accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) saved $954 million from 2013 to 2015. However, a new Dobson DaVanzo & Associates analysis,...RCCH Uses Predictive Analytics to Boost Claim Denials Management
Predictive analytics are key to implementing an effective and efficient claim denials management strategy that tackles the right denials at the right time, according to the Vice President of Revenue...Sponsored by symplr