Category: Revenue Cycle Management

electronic-payment-key-to-streamlining-healthcare-claims-management

Electronic Payment Key to Streamlining Healthcare Claims Management

The complexity around healthcare claims management is a major pain point for provider organizations, big and small. The increasing cost of claims coupled with a complex system of many payers, each with their own rules and requirements, creates administrative burdens and obstacles for providers. Ultimately, this complex system impacts the patient experience, as patients must […]
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how-the-affordable-care-act-impacted-small-group-coverage-trends

How The Affordable Care Act Impacted Small Group Coverage Trends

Small group coverage did not pursue the trends that many experts anticipated after the Affordable Care Act went into effect. From 2013 to 2020, small group coverage has maintained a fairly stable environment, researchers from the Urban Institute found. The researchers used the Medical Expenditure Panel Survey Insurance Component (MEPS-IC) in order to assess changes […]
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cyber-technology-for-medicare-audits

Cyber Technology for Medicare Audits

This is what providers can expect in 2022 in the form of new technology audits. During 2022, healthcare providers will see more options to exploit cyber technologies designed to aid them in management of Medicare audits. Below we review the informational challenges of managing an audit, and then turn to the types of cyber solutions […]
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health-affairs-study-medicare-coverage-denials-more-common-than-medicare-advantage

Study examines differences in coverage denials for traditional Medicare, MA

Traditional Medicare coverage rules make up the bulk of denied services and spending compared to a Medicare Advantage plan, according to a new study in the latest Health Affairs issue. The study, led by the University of Pennsylvania, Harvard University and CVS Health, relied on Medicare Advantage claims that were denied for beneficiaries enrolled with […]
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many-states-hit-hard-by-covid-19-limit-telehealth-practice-report-finds

Many States Hit Hard by COVID-19 Limit Telehealth Practice, Report Finds

States like New York, California, and Washington have laws that block interstate telehealth, while only three states allow all providers to easily practice telehealth across state lines. Though telehealth use reached new heights during the COVID-19 pandemic, a new report shows that some of the states that were hit the hardest by the novel coronavirus […]
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CMS COVID-19 Vaccination Rule

Centers for Medicare & Medicaid to Enforce Its COVID-19 Vaccination Rule, Sets New Deadlines

The Centers for Medicare & Medicaid Services (CMS) will enforce its COVID-19 vaccination requirement in 25 states, the District of Columbia, and other territories, according to an update released on December 28, 2021. CMS is enjoined from enforcing its COVID-19 vaccination rule in the other 25 states, which are involved in a case challenging its […]
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