The COVID-19 pandemic continues to send more Utah residents to hospitals. Given the rise in hospital visits, addressing the need for cost transparency and clarity for patients has become more urgent than ever. Surprise Medical bills, a familiar...
More InfoPrior authorizations, or prior approvals, are strategies that payers use to control costs and ensure their members only receive medically necessary care. The cost-control process requires providers to acquire advance approval from payers before...
More InfoDenied claims are one of physicians’ chief complaints when it comes to dealing with payers. To a certain extent, every practice deals with claim denials. It’s those practices that eliminate the most common reasons that experience a...
More InfoThe focus on electronic health record implementation has turned to how to make use of the vast data stored within to improve revenue cycle operations (IRF). Proposed rule calls amending regulations clarifying the determination as to whether a...
More InfoCPT modifiers help payers understand all of the distinct services and procedures physicians perform. As the scope of practice for today’s internists continues to expand, these modifiers are also increasingly required to ensure accurate...
More InfoProviders and payers are increasingly adopting electronic claims management transactions, but remittance advice and prior authorizations are still largely manual. Electronic claims management adoption by plans and providers is at or above 80...
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