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

Reimbursement News

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

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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

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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?

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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

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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

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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

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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

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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

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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....

3 Strategies to Improve Healthcare Supply Chain Management

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The evolution and progression of supply chain and reimbursement tactics and procedures within the healthcare industry serves as a keen focal point requiring acute attention to detail if success is to be met. The following is a compilation of...

How to Rescue Revenue Cycle with Medicare Appeals Pending

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The rehabilitation needs of Medicare beneficiaries within the state of California may be in jeopardy. Payment for hundreds of thousands of claims for services is being denied. Most of these denials are reportedly invalid, confirms past appeal...

HHS Urged to Resolve Pending Medicare Appeals in Filed Suit

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Casa Colina Hospital and Centers for Healthcare recently filed suit to require timely Medicare patient care appeals mandated under federal law.  The Medicare program is denying payment for hundreds of thousands of claims for services....

Are the Cheapest Provider-Owned Health Plans More Expensive?

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The demise of the fee-for-service model may be unsuccessful in producing the most economically efficient health plans, confirms a new study from HealthPocket. Demonstrating significant findings that are simply “contrary to expectations,”...

Unreliable Health Plan Provider Directories Burden Providers

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Under the establishment of the Affordable Care Act (ACA), millions of people have enrolled in new health insurance plans via the health insurance marketplace. When signing up for these new plans, consumers rely on information provided to them...

Is the ACA Working as Intended to Improve Healthcare Access?

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Is the Affordable Care Act (ACA) living up to its full potential or is it more a matter of all healthcare hands on deck? In past interviews with RevCycleIntelligence.com, healthcare experts and leaders from both athenahealth and the Robert...

Value-Based Payment Preparation Requires Cost Measurement

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Value-based payments present numerous challenges to healthcare providers. Healthcare finance departments may have a bit of catching up to do. Following an announcement from the Centers for Medicare & Medicaid Services regarding an actively...

How to Manage ACO Risk with Value-Based Purchasing Programs

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The game of Risk is more than just a generally entertaining board game about world supremacy. It is also a critical game healthcare providers, payers, and hospital executives play daily regarding their own revenue cycle management objectives....

Twelve Things to Know Now About Value-Based Reimbursement

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The healthcare industry continues to move away from fee-for-service and advance further into the realm of value-based care. But at what pace? Perhaps rather quickly. Some healthcare experts and leaders confirm an alleged hastening pace means...

Rural Hospitals Address Medicare Reimbursement Cut Concerns

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Rural hospitals may be losing the Medicare reimbursement battle. Legislative pushes are being considered by Congress to alleviate the possible financial death of the rural hospital as reimbursement cuts continue to weaken the financial backbone...

EHRs Advance Medicaid Reimbursement and Stabilize Insurance

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The meaty 1,024 pages of the Affordable Care Act (ACA) call for the vast expansion of healthcare coverage, the active promotion of decreased healthcare costs, and enhanced quality care. In the midst of ACA expansion efforts, Medicare and Medicaid...

Next Generation Analytics Demand Actionable Results

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The value-based reimbursement movement has a leader. That leader is the Centers for Medicare & Medicaid Services (CMS). Indeed, there has been a great deal of hustle and bustle regarding many recent initiatives from CMS,...

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