CMS is floating the idea of implementing another pre-claim review of Medicare claims submitted by home health agencies in at least five states, according to a recent notice of proposed information...
HHS recently announced an expanded alternative dispute resolution process that aims to reduce the growing Medicare appeals backlog.
The expanded Settlement Conference Facilitation (SCF) process...
Tennessee-based Vanderbilt University Medical Center (VUMC) may have reported increased revenue in the first nine months of the 2018 fiscal year, but the medical center finished with lower operating...
Moving accountable care organizations (ACOs) to Medicare Shared Savings Program (MSSP) tracks with downside financial risk may not help the accountable care initiative generate savings, according to a...
The American Medical Group Society (AMGA) recently recommended CMS focus on improving accountable care organizations (ACOs) and the Medicare Shared Savings Program (MSSP) rather than put forth a new...
Almost 69 percent of healthcare organizations use more than one vendor solution for revenue cycle management. However, these organizations tended to have more problems with claim denials management, a...
Hospital prices for the privately insured depend on where a facility is located and how consolidated its market is, a recent Health Care Pricing Project analysis revealed.
Using insurance claims from...
Approximately 80 percent of hospitals leaders in a new Black Book survey said they were vetting or considering outsourcing full revenue cycle management by 2019.
The demand for revenue cycle...
A new survey from Waystar and HIMSS Analytics shows that patients and providers are not seeing eye to eye when it comes to medical billing and collecting patient financial responsibility.
The survey...
Healthcare organizations are starting to implement new patient accounting systems to achieve clinical integration, and most are going to Cerner or Epic EHR for the revenue cycle management technology,...
Delayed payments stemming from claim denials are significantly impacting hospital revenue cycles, taking an average 16.4 more days to pay compared to claims that have not been denied, a new analysis...
The Medicare Shared Savings Program (MSSP) is requiring the 82 accountable care organizations (ACOs) that started in upside-only financial risk tracks in 2012 or 2013 to take on downside financial risk...
The American Society of Addiction Medicine (ASAM) and the American Medical Association (AMA) recently unveiled an alternative payment model that aims to improve care and reduce costs associated with...
CMS is appealing a recent federal court decision that barred the agency from enforcing a 2017 final rule and two sub-regulatory articles from 2010 in Missouri. The federal agency stated that rule and...
An elderly patient presses the nurse call button to get assistance with standing up and using the toilet, while another patient in the next room presses the button to get help with changing the TV...
Provider organizations failed to achieve their risk-based revenue goals in 2017, according to the most recent State of Population Health survey by Numerof & Associates.
The survey of healthcare...
Moving from traditional block scheduling for the operating room (OR) to more of a service-based system that used machine learning maximized OR efficiency and increased revenue by $10 million across...
A federal judge is calling on the American Hospital Association (AHA) to recommend strategies to reduce the growing Medicare appeals backlog, a recent court order stated.
According to the AHA’s...
Medical billing for Medicaid fee-for-service claims proved to be the most complex across all insurers. The public payer had a claims denial rate 17.8 percentage points greater than the rate for...
Professional and facility coding describe two very different aspects of a healthcare. But breaking down the wall between the departments has the potential to boost coding productivity and improve clean...
