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

Reimbursement News

4 Value-Based Care Models Demanding New Long-Term Focus


Value-based care models are taking over the healthcare industry. Providers are struggling to stay ahead of the reimbursement curve, some smiling more than others when they consider where their ROI currently sits. The transition away from...

HHS, CMS Speak Out on CMS’s Innovation Center Pilot Project


Medicare reimbursements are preparing to emerge from a fee-for-service caterpillar’s cocoon to a value-based butterfly. The newly announced Accountable Health Communities [AHC] model – a CMS Innovation Center Pilot...

3 Snags of Expensive Affordable Care Act Deductibles, Copays


Money woes stemming from expensive Affordable Care Act (ACA) exchange policies may be hindering communication efforts between physicians and patients. Costly deductibles and copays mean patients may be more commonly skipping chats about drug...

A Very Happy New Year from!


2015 was The Year of ICD-10. News of grace period delays, deadline extensions, claims management woes, and discussions about a proposed freeze topped our most popular articles of the year. “The long-awaited U.S. transition to...

3 Hard Reimbursement Questions Physicians Are Afraid to Ask


Physicians sought answers to many pressing reimbursement questions this year. 2015 saw heightened anticipation of reimbursement delay and claims denials once ICD-10 kicked into gear, ongoing discussion among physicians nationwide about how a...

5 Claims Reimbursement Questions and Answers


Money talks and the healthcare industry is listening. Claims reimbursement was one of many weighty revenue cycle management topics the healthcare industry kept an ear out for this year. From the art of claims scrubbing to figuring out how to...

Hospitals Facing More Payment Claims Audits, Costly Denials


Hospitals are allegedly trying to do the best they can, even when money is slow to come in. Nearly half of all Recovery Audit Contractor claim denials are denied by hospitals, according to a new report from the American Hospital Association (AHA)....

Top 7 New Strategies for Revenue Cycle Management Excellence


Money may be the root of all evil, but it is also the root of the healthcare industry. Revenue cycle management, based upon the straightforward notion of continuously staying in the black, is about getting paid, and expediently so. Within the...

Top 6 Trending Payment Models Demanding New Long-Term Focus


Time is money, especially when it comes to healthcare. Paying for outcomes gained instead of mere services rendered is the new name of the healthcare game. This means the simple notion of paying for multiple physician visits, medical...

Why Value-Based Care Yields Lower Cost, Higher Quality Care


Value-based care is in the lead compared to its fee-for-service competitor, according to Humana’s new Medicare Advantage population health results. “Members treated under the care of providers in value-based reimbursement models with...

Top 4 Strategies to Achieve Affordable Value-Based Care


Value over volume is the name of the revenue cycle game, with the reimbursement concept of “less is more” taking precedence. With the transition to value-based care underway, here are some top collected strategies for healthcare providers...

Pew Urges CMS to Consider Physician-Focused Payment Models


Lack of financial reimbursement may be preventing physicians from initiating imperative end-of-life discussions about a patient’s definitive health desires and wishes. The Pew Charitable Trusts (Pew) is concerned with the lack...

Humana Pays Physician Groups $77M for Value-Based Outcomes


As the fee-for-service realm dissipates and the value-based reimbursement model nears its completed transition in coming years, Humana is granting sizable financial rewards for those physician groups yielding quality care outcomes....

Low Reimbursement, High Costs Threaten Physician RCM Success


The three leading concerns among physicians' predictions regarding profitability drops are declining reimbursements, increasing personnel expenses, and issues regarding supplies, says CareCloud’s recently released third annual...

How Does Meaningful Use Impact Revenue Cycle Management?


Several questions are imperative to consider in terms of recent news related to the long-awaited final use for meaningful use modifications and Stage 3 Meaningful Use requirements: How meaningful is meaningful use when it comes to revenue...

GAO Announces New Physician-Payment Model Advisory Committee


The Government Accountability Office (GAO) has announced 11 new initial committee members appointed to the Physician-Focused Payment Model Technical Advisory Committee. Selected members, who will serve intentionally zigzagged terms...

Why Focusing on Hospital Readmission Causes Is Essential


The ongoing payment transition from volume to value is bringing the concept of forced alignment into the spotlight. Hospitals, unsure what new outpatient services are best to implement, are now focused on making effective choices. Are such choices focused...

Performance-Based Pay Hot as Healthcare Exec Salaries Rise


Median base healthcare salaries are on the up and up, according to recently released results within a 2015 executive healthcare and hospital compensation survey press release from Sullivan, Cotter and Associates. Data collected from...

How to Achieve Value Within the Value-Based Care Transition


The Department of Health and Human Services (HHS) is on a mission to associate 90 percent of Medicare payments to value within the next three years and Congressional passage of the Medicare Access and CHIP Reauthorization Act of 2015...

Survey Shows Payment, Workflow of Private Health Practices


Private practices and traditional, fee-for-service provider facilities are two primary operational models in the healthcare industry. While either practice model has its own unique benefits, it is clear that their payment models are quite different....


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