Revenue Cycle Management Archives - Page 32 of 48

Alignment Expands Medicare Advantage for Seniors in 3 States

The payer will debut its Medicare Advantage plans in select Arizona counties and expand coverage to additional counties in North Carolina and Nevada. Alignment Healthcare (Alignment) is extending its Medicare Advantage (MA) footprint in Arizona, North Carolina, and Nevada to provide coverage for more senior beneficiaries. Starting in 2022, Alignment will introduce its MA health […]

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Experts Consider Impacts of SCOTUS Affordable Care Act Decision

The Supreme Court’s decision in California v Texas ended one lawsuit against the Affordable Care Act but may have left room for future legal action. Since the Supreme Court dismissed California v Texas on June 17, payers and healthcare leaders have vocalized their support for the decision, their readiness to continue building on the Affordable […]

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More than 30% of hospitals are near the ‘danger zone’ of denial rates

The pandemic has only made the trend worse, as 33% of hospital executives report average claims denial rates of 10% or more. Hospital claim denial rates have hit new highs, with a 20% increase in those rates over the past five years, suggesting that better claims denial management processes are necessary, finds a new […]

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Beaumont Health, Spectrum Health Announce Merger Plans

Merging the two health systems would create the largest system in Michigan, operating 22 hospitals and 305 outpatient centers, as well as a health plan. Michigan-based Beaumont Health and Spectrum Health have announced that they plan to merge to create the largest health system in the state. The announcement dropped yesterday said the two […]

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Pros, Cons of Non-Emergency Medical Transportation Benefits

MACPAC’s June 2021 report to Congress included findings about non-emergency medical transportation benefits in Medicaid programs that could prove useful for benefits design. A small fraction of the Medicaid population utilizes non-emergency medical transportation (NEMT) benefits, but for that community of beneficiaries NEMT programs can be indispensable, a MACPAC report recently found. It has been […]

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New Provider Relief Fund Rules Give More Time to Use, Report Money

HHS recently updated Provider Relief Fund reporting requirements, extending the period of availability of funds and reporting periods. The update to the Post-Payment Notice of Reporting Requirements states that clinicians now have a period of availability of funds based on the date they received the payment, rather than the original deadline of June 30, 2021. […]

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AAMC Predicts 37K to 124K Physician Shortage by 2034

The US could see a physician shortage of 37,800 to 124,000 doctors by 2034, including shortfalls in both primary and specialty care, according to the latest numbers from the Association of American Medical Colleges (AAMC). Primary care will see a shortage of 17,800 to 48,000 physicians between 2019 and 2034, while specialty care is slated […]

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Emergency physicians call United healthcare’s ED denial Policy ‘Dangerous’

The American College of Emergency Physicians said that it “firmly believes that the new policy is in direct violation of the federal Prudent Layperson Standard.” Calling it a “dangerous decision” and a “scare tactic,” the American College of Emergency Physicians (ACEP) is condemning UnitedHealthcare’s recent announcement to retroactively deny emergency care claims. “ACEP firmly believes […]

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CMS Increases Medicare Payments for At-Home COVID-19 Vaccinations

CMS will increase Medicare payments by $35 per dose to administer at-home COVID-19 vaccines in an effort to increase the vaccination rate among beneficiaries. Medicare payments will increase by $35 per dose for providers who administer at-home COVID-19 vaccinations for Medicare beneficiaries, CMS announced today. In alignment with President Biden’s goal of ensuring vaccine […]

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Over Third of Hospital Execs Report Claim Denial Rates Nearing 10%

Average claim denial rates are between 6% and 13%, but some hospitals are nearing a “danger zone” after COVID-19, a survey shows. Hospital claim denial rates are at an all-time high, signaling a need for better claims denial management, a recent survey from Harmony Healthcare reveals. The healthcare industry has seen a 20 percent increase […]

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Category: Revenue Cycle Management

Alignment Expands Medicare Advantage for Seniors in 3 States

Experts Consider Impacts of SCOTUS Affordable Care Act Decision

More than 30% of hospitals are near the ‘danger zone’ of denial rates

Beaumont Health, Spectrum Health Announce Merger Plans

Pros, Cons of Non-Emergency Medical Transportation Benefits

New Provider Relief Fund Rules Give More Time to Use, Report Money

AAMC Predicts 37K to 124K Physician Shortage by 2034

Emergency physicians call United healthcare’s ED denial Policy ‘Dangerous’

CMS Increases Medicare Payments for At-Home COVID-19 Vaccinations

Over Third of Hospital Execs Report Claim Denial Rates Nearing 10%

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