In light of new funding from Congress, HHS must reduce the Medicare appeals backlog according to annual deadlines and percentage amounts, a judge ordered. HHS must eliminate the Medicare appeals backlog at the Administrative Law Judge (ALJ) level...
More InfoWhen it comes to artificial Intelligence and machine learning, most often we hear them discussed in a clinical context. But that’s not the only realm where AI and ML could make an impact. In fact, revenue cycle is well-suited to AI and MI...
More InfoThree experts on revenue cycle and operations at ASCs gathered at the Becker’s ASC 25th Annual Meeting: The Business and Operations of ASCs conference in Chicago Oct. 19 to discuss how administrators can improve reimbursement per case at...
More InfoImagine buying a plane ticket, but the fare only covers your seat, the fuel, the gate attendant, and the peanuts. You have to pay the pilot separately. You are sitting on the plane and, unbeknownst to you, the pilot scheduled to fly your plane is...
More InfoThe rules of other consumer commerce sectors somehow do not apply to medical billing. Stop and think about that for a moment. It’s easier to make sense of how much we spend for goods and services such as groceries, clothing, and gasoline because...
More InfoFor 2019 and 2020, we will see no changes to our outpatient, office-based evaluation and management (E&M) services, but things will change come 2021 – that according to the E&M Final Rule released Thursday by the Centers for Medicare...
More InfoOver the last few years, healthcare has shifted from a standardized, product-centric experience to one that is more personalized. Patients now have access to more information on providers than ever, meaning they have more choice when selecting...
More InfoMAs are taking advantage of excessive denials to reduce payments to providers. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently found that between 2014 and 2016, a total of 75 percent of all...
More InfoThere are numerous patient engagement strategies aimed at improving care. What are the outcomes that show these solutions are working? Patient engagement affects every patient interaction across the care continuum. Accordingly, the outcomes that...
More InfoClaim denial prevention and management is crucial for a hospital’s financial health. Without an effective approach, organizations may lose or experience delays with reimbursement. A Change Healthcare study found a typical health system...
More InfoCMS proposes to ease burdens on providers. When it comes to the ever-changing Centers for Medicare & Medicaid Services (CMS) agency rules and regulations, one can’t help but be reminded of the classic tune by The Byrds: “to everything (turn...
More InfoNearly all healthcare decision makers recently surveyed by KLAS said their organization saw financial gains after implementing a clinical documentation improvement solution. Provider organizations are seeing financial improvements after...
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