Category: Revenue Cycle Management

Prior Authorization Reform in Medicare Advantage | Case Studies | AllZone Management Services Inc.

Prior Authorization Reform in Medicare Advantage

Prior Authorization reform in Medicare Advantage would help relieve administrative burden for medical groups and reduce patient care delays, MGMA said. The Medical Group Management Association (MGMA) has urged CMS to implement policies that support prior authorization reform and value-based care contracts within the Medicare Advantage program. MGMA submitted comments to CMS Administrator in response […]
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Home Health Medicare Reimbursement

Recent Updates on Home Health Medicare Reimbursement

AHA said that the 2.7 percent Medicare reimbursement update for home health agencies does not accurately reflect the financial challenges that home health agencies have faced during the pandemic. The American Hospital Association (AHA) has urged CMS to reconsider the Medicare reimbursement update for home health agencies proposed in the Calendar Year 2023 Home Health […]
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High-Cost-Connection-to-Support-Better-Health-Equity

Breaking the High Tech/High Cost Connection to Support Better Health Equity

Healthcare costs continue to rise in this country. Healthcare spending totaled $3.8 trillion in 2019, $11,582 per person. In 2028, it projects that spending will rise to $6.2 trillion, or $18,000 per person. These increases are happening at the same time the COVID-19 pandemic revealed systemic inequities in health equity, and how difficult it is […]
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Physician-Fee-Schedule-Proposed-Rule-2023

Newly Revised CPT E&M Guidelines: Physician Fee Schedule Proposed Rule

A major revision of the Current Procedural Terminology (CPT) Evaluation and Management (E&M) Guidelines for Office and Outpatient Visits (O/O Visits), Split/Shared Visits, and Critical Care Time billing was implemented Jan. 1, 2021. You would think that all office-based providers would have been made aware of this and changed their documentation accordingly, but there is […]
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Revenue-Growth-in-Q2-2022

UnitedHealth Group saw a Revenue Growth of 13% in Q2

Health insurer reports second quarter numbers, boosted by performance of subsidiaries UnitedHealthcare and Optum Health. UnitedHealth Group reported a promising second quarter, achieving 13% revenue growth behind member expansion at UnitedHealthcare and value-based arrangements at Optum Health. The payer’s Q2 results were highlighted by revenue growing from $71.3 billion to $80.3 billion year-over-year, while earnings […]
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