Category: Revenue Cycle Management

leaked-cms-report-targets-medicare-noncompliance-at-ca-hospital

Leaked CMS Report Targets Medicare Noncompliance at CA Hospital

A leaked CMS report targeting HCA Healthcare-owned Good Samaritan Hospital in California warns the hospital to fix Medicare noncompliance issues or risk termination. A leaked CMS report put HCA Healthcare-owned Good Samaritan Hospital in California at risk of program termination by October if they fail to fix Medicare noncompliance issues that resulted in patient harm. […]
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cms-seeks-to-improve-healthcare-outcomes-and-drive-down-costs

CMS Seeks to Improve Healthcare Outcomes and Drive Down Costs

CMS’ proposed actions are intended to increase price transparency, access to care, patient safety, positive healthcare outcomes, and health equity. On July 19, 2021, the Centers for Medicare & Medicaid Services (CMS) announced new proposed actions to address the health equity gap, decrease mounting healthcare costs, and increase medical accessibility and patient quality of care. […]
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hospital-volumes-climbing-2019-levels

Hospital Volumes Climbing To 2019 Levels

  Providers also said they expect patient demand to exceed capacity in psychiatry, orthopedic surgery, cardiology, and gastroenterology in the next six months. Hospital volumes in the United States are approaching 2019 levels, finds new research from McKinsey & Company The firm surveyed leaders at 100 private sector hospitals across the United States in late […]
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Battling EHR dissatisfaction with 4 personalization techniques

  Personalizing your EHR is a proven best practice for new implementations and major system upgrades. These four new approaches boost physician satisfaction and improve EHR usability. When EHRs first emerged 20 years ago, system vendors pushed for standardization. Consistency was considered the only pragmatic way to support end users and enterprise-wide systems. EHR customization […]
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cms-prior-authorization-operational-and-financial-impact

CMS Prior Authorization—operational And Financial Impact

CMS has expanded the prior authorization requirement to two new service categories within hospital outpatient department services. The Centers for Medicare & Medicaid Services (CMS) has expanded the prior authorization requirement for two additional hospital outpatient department (OPD) services. Effective with date of service July 1, 2021, CMS has expanded the prior authorization requirement to […]
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follow-these-5-steps-to-ensure-hipaa-compliance-when-texting-patients

Follow these 5 steps to Ensure HIPAA-compliance when texting patients

As long as providers remain HIPAA-compliant, they will be able to text patients with ease and see all the benefits that it brings — including stronger patient loyalty, more revenue, and more referrals. Many people, and that includes patients, prefer to text because it’s quick, easy, and convenient. Texting is incredibly effective for medical practices […]
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unitedhealthcare-loses-medicare-advantage-overpayment-suit.

UnitedHealthcare loses Medicare Advantage overpayment suit

Dive Brief: A federal appeals court has ruled against UnitedHealthcare, the biggest private payer in the U.S., and reversed a 2018 decision overturning Medicare’s overpayment rule requiring insurers to refund reimbursement to CMS within 60 days if they learn a diagnosis lacks medical record support. UnitedHealthcare argued in court in November the overpayment rule was […]
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Hospital Price Transparency Strategies for Compliance, Patients

Hospital price transparency is now a requirement from CMS, but providers should be going beyond the rule to ensure transparency meets patient demands, too. Hospital price transparency goes beyond just compliance with federal regulations. Patients are also demanding more transparent pricing information from their providers in order to make more informed decisions about their healthcare. […]
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Dos And Don’ts For Managing Inpatient-to-observation Status Downgrades

  In the newest episode of the HealthLeaders Revenue Cycle Podcast, Charlie Brown, MBA, a former hospital executive and vice president of revenue cycle at a consulting firm, provides actionable steps for mitigating status downgrades and dealing with them effectively to ensure that organizations receive the full reimbursement for the services they provided. In his […]
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