There are the standard reasons medical claims are denied, such as putting the wrong modifier on a code or putting the diagnoses in the wrong sequence. But did you know that some reasons are not the fault of medical coding? 5 Ways Your Medical...
More InfoIn April, the U.S. Department of Health and Human Services (HHS) announced five new alternative payment models for primary care, known as the CMS Primary Cares Initiative. The five alternative payment models are: Primary Care First Primary Care...
More InfoHospitals and health systems are exploring ways to revenue cycle transformation processes to offset financial pressures. However, shifting to a new business model for revenue cycle management can be challenging. The hospital revenue cycle has...
More InfoOn May 2, the Centers for Medicare and Medicaid Services (CMS or the Agency) announced in a press release that it will be changing how frequently the Agency reviews applications for new and revised Level II codes under the Healthcare Common...
More InfoDual eligible Medicare Advantage beneficiaries had 42.1% less emergency room visits than their fee-for-service counterparts. The cost of care and rate of hospitalizations for dual eligible Medicare Advantage (MA) beneficiaries was considerably...
More InfoCAQH CORE, a healthcare industry-led operating standards group, has announced new rules that move the healthcare industry closer to fully automating the prior authorization process. “Not only do the operating rules represent a foundational step...
More InfoWhile both providers and insurers have found it difficult to agree on a solution to surprise billing, experts on both sides expressed support Tuesday for banning the practice – thereby forcing insurers and providers to work out payment...
More InfoPresident Donald Trump said it’s time for Congress to pass a law that stops hospitals and insurance companies from hitting patients with surprise medical bills. “We’re going to hold insurance companies and hospitals accountable,” Trump...
More InfoQ: Are there any updates on the Evaluation and Management code requirements? A: The American Medical Association (AMA) has now weighed in with their E/M coding requirement modifications, which means that all payers will be affected in 2021. If...
More InfoHealthcare is a top priority for American voters and there aren’t dramatic differences by ideology, according to a new survey. Adopted from the marketing industry, customer segmentation allows health systems to further customize the patient...
More InfoHealthcare is a top priority for American voters and there aren’t dramatic differences by ideology, according to a new survey. Key Takeaways Thirty six percent of Americans ranked healthcare as the most important policy issue facing the...
More InfoKeen on giving Americans in federally-funded programs more control over their healthcare, the U.S. Department of Health and Human Services (HHS) has been working closely with past and present administrations to establish regulations governing...
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