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

Reimbursement News

AHA Endorses Quality Reporting Software for Value-Based Care

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The American Hospital Association (AHA) recently announced that it has endorsed ENCOR Quality Reporting and Management Solution from Medisolv Inc. for providing services and products that help member healthcare providers improve value-based care....

VA Creates Call Center to Reduce Claims Reimbursement Delays

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The Department of Veterans Affairs (VA) has established a community care call center to assist veterans and healthcare providers who are experiencing issues with debt collection because of incorrect or delayed claims reimbursement payments under...

Value-Based Care Reimbursement Needs Greater Customization

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With rising healthcare spending found throughout the US, the federal government has put greater focus on value-based care reimbursement than ever before. Healthcare providers and payers are seeking ways to move beyond fee-for-service payment...

Direct Physical Therapy Access Could Reduce Healthcare Costs

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When it comes to healthcare costs, the federal government, medical providers, and payers are attempting to reduce rising spending and adopt value-based care reimbursement.  A number of different strategies have been implemented including...

Value-Based Reimbursement May Not Bring Benefits for SNF Care

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CMS has released the Skilled Nursing Facility Utilization and Payment Public Use File, a dataset on the care skilled nursing facilities (SNF) provided to Medicare beneficiaries in 2013.  The data raises questions about the effect of...

CMS Releases 2016 Results for Value-Based Care Program

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The Center for Medicare and Medicaid Services (CMS) released the results for calculating the 2016 Value Modifier, which will come as financial boost to some and hindrance to others. Out of the 8,395 eligible physician groups, which satisfactorily...

4 Healthcare Revenue Cycle Outcomes Make Headway at HIMSS16

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With the HIMSS16 conference in Las Vegas, Nevada coming to an end, it is useful to look back and see which avenues are making an impact on the healthcare revenue cycle among providers. Both health IT solutions and new reports coming out of the...

HIMSS: Providers Not Ready for Value-Based Care Reimbursement

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In recent years, the healthcare industry and the revenue cycle of providers has had a much greater target of achieving value-based care reimbursement and moving away from fee-for-service payment systems. The Centers for Medicare & Medicaid...

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...

How EHR Data Analytics Influences Value-Based Reimbursement

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As the transition away from traditional, fee-for-service payment models towards value-based reimbursement continues, the implementation of electronic health records (EHRs) is becoming the rule rather than the exception. The Centers for Medicare...

Revenue Cycle Management Success is About the Fundamentals

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Revenue cycle management success is the heart of any healthcare organization. Defined as the clinical and administrative management of claims management, payment, and revenue production, revenue cycle management is in essence one large financial...

Why Executives are Demanding Supply Chain Management Value

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As hospitals transition into the value-based payment realm, they remain focused on effectively slashing costs. Supply chain management is the second largest expense for healthcare providers, according to a study from Cardinal Health and SERMO...

How the Affordable Care Act Refines Revenue Cycle Management

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The Affordable Care Act (ACA) provides many greater opportunity for healthcare providers to strengthen their revenue cycle operations. As a consumer-driven revenue cycle management is becoming the new norm, the ACA plays an active role in healthcare’s...

What Are the Greatest Revenue Cycle Management Challenges?

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RevCycleIntelligence.com recently polled over 60 readers to assess revenue cycle management challenges and opportunities, from the front-end, to the back-end, and everything in between. Readers said collecting payment from a patient in a timely...

4 HIMSS16 Revenue Cycle Management, Value-Based Care Focuses

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The topics of revenue cycle management innovation and value-based care will be of key importance at HIMSS16, one of the largest healthcare information technology (IT) conferences of the year, held next month in Las Vegas. Promoting financial...

CMS Final Rule Revises Medicaid Reimbursement, Drug Rebates

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Medicaid reimbursement improvements are underway, according to a final rule from the Centers for Medicare & Medicaid Services (CMS). The rule – CMS-2345-FC – provides greater detail about Medicaid reimbursement and rebate calculation....

Why Flawed Alternative Payment Model Design Holds MACRA Back

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Alternative Payment Models (APMs) do not adequately address payment system problems, according to a new report from the Center for Healthcare Quality and Payment Reform (CHQPR). Healthcare payment reform is apparently progressing at a snail’s...

Value-Based Care Models Still Pose Opportunities, Challenges

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The value-based care model is allegedly winning the claims reimbursement race, leaving its fee-for-service competitor in the dust. How valid is the widespread claim that value-based reimbursement models are tied to higher care quality levels,...

High Patient Experience Ratings Up Revenue Cycle Management

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Positive patient experience ratings generate a healthy and happy revenue cycle management, according to Press Ganey’s new white paper. But healthcare payment reform challenges may be keeping providers from seeing more revenue...

Providers Face Value-Based Care’s Financial Reality, Demand

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The value-based care transition is a sizable endeavor for healthcare providers. Jumping in head first into dark payment water takes bravery, experience, and knowledge. Although healthcare leaders are often hesitant to fully commit to...

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