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

Practice Management News

Appeals Court Supports FTC Request to Stop PA Hospital Merger

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A federal appeals court recently reversed a lower court’s decision to deny the Federal Trade Commission’s (FTC) request to temporarily pause the hospital merger between Penn State Hersey Medical Center and PinnacleHealth System until...

Cerner Earns Top Revenue Cycle Management Outsourcing Vendor

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Black Book Market researchers ranked Cerner Business Office Services as the top rated end-to-end physician revenue cycle management outsourcing vendor. Cerner earned high marks on eighteen key performance indicators relating to client experience...

Lessons Learned from the First Year of ICD-10 Implementation

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With the anniversary of ICD-10 compliance approaching, many providers are looking back on the past year to see how the new coding system has affected their organizations as well as preparing for fast approaching updates. At Baptist Health South...

HHS Unveils Simpler Medical Billing Process Challenge Winners

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The Department of Health and Human Services (HHS) recently announced two winners of a medical billing competition that sought a simpler patient payment collections experience. The “A Bill You Can Understand” competition, sponsored...

Former Hospital Exec Pays $1M to Settle Medicare Fraud Case

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The former chief executive officer of a South Carolina-based healthcare system agreed to pay $1 million and be excluded from federal healthcare programs for four years to resolve a 2013 Medicare fraud case, according to the Department of Justice...

Demand for Physician Assistants Led to Increased Pay in 2015

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Physician assistants saw a 3.4 percent increase in median provider compensation between 2014 and 2015, according to a report from the American Academy of PAs (AAPA). Comprising feedback from approximately 16,000 respondents, the 2016 AAPA Salary...

Health Systems, Physicians See Significant Revenue Losses in 2015

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Both integrated healthcare systems and private physician practices saw operating losses in 2015, according to a revenue cycle management survey conducted by the American Medical Group Association. Integrated healthcare systems saw an operating...

85% of Orgs Looking to Replace Revenue Cycle Management Systems

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Eighty-five percent of provider organizations, hospitals, and physician practices are currently seeking to replace their healthcare revenue cycle management systems or are deciding if it is time to switch, according to a new survey from Black...

DoJ Charges Providers in Medicare Fraud Cases, Settles Others

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Medicare fraud cases have the potential to drain the federal healthcare program of millions of dollars while also putting beneficiaries at risk of receiving unnecessary or low-quality care. In response, the federal government has ramped up its...

Children’s Hospitals Vulnerable to Uncompensated Care Cuts

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Pediatric healthcare providers, especially those practicing in free-standing children’s hospitals, could face serious financial setbacks following upcoming uncompensated care payment reductions as mandated by the Affordable Care Act, a...

CBO: Future Hospital Profitability Requires More Productivity

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To stabilize hospital profitability at a six-percent average profit margin by 2025, providers must increase hospital productivity to offset Affordable Care Act provisions to decrease federal reimbursement rates and implement value-based penalties,...

Value-Based Care Spurs Higher Physician Consolidation Rates

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More healthcare providers are moving to larger group practices in order to gain access to more resources to effectively implement value-based care and risk-based reimbursement models, according to a recent Datawatch report in Health Affairs....

Using Data Analytics to Decrease Claims Denials, Boost Revenue

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Claims denials typically represent one of the largest revenue cycle bottlenecks in most healthcare organizations.  However, slowing down to determine why claims are being denied hasn’t traditionally been an option. The light at the...

WEDI Guide Suggests New Electronic Fund Transfer, ERA Standards

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The Workgroup for Electronic Data Interchange (WEDI) recently released a guide that advised all healthcare stakeholders to implement Automated Clearing House (ACH) Electronic Funds Transfers (EFT) and Electronic Remittance Advice (ERA) standards...

How a Small Hospital Developed Lean Supply Chain Management

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When hospitals start to dig into how their organizations can reduce healthcare costs without lowering care quality, many run the risk of overlooking several cost-cutting opportunities in their healthcare supply chain management process. But developing...

Reducing Use of Low-Value Services Cuts Healthcare Costs

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Providers can substantially lower their healthcare costs by reducing the use of low-value services, even though these services account for a substantially small portion of healthcare spending, according to a recent study by the RAND Corporation...

88% Improve Claims Submissions Using Revenue Cycle Analytics

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According to a Navicure survey, medical organizations that used a revenue cycle analytics or business intelligence solution were able to boost performance on key healthcare revenue cycle metrics. About 88 percent of participants reported that...

Epic Systems Tops List of Hospital RCM Technology Users

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The healthcare industry finds itself at a turning point in regard to reimbursement. Fee-for-service reimbursement is giving way to alternative payment models that emphasize value over volume, but it remains a financially significant feature that...

Medicaid Program Advances Patient Engagement, Interoperability

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At the HIMSS16 conference in Las Vegas, the Centers for Medicare & Medicaid Services (CMS) will be presenting a discussion revolving around how health IT applications could incentivize patient engagement. The panel discussion will incorporate...

Federal Agencies Advance Alternative Payment Models in Medicine

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In recent years, the federal government has positioned the healthcare industry to adopt new reimbursement tactics aimed at strengthening pay-for-performance initiatives. These regulations consist of alternative payment models such as bundled...

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