The average cost of debunking a denial is $25 per claim, not to mention the continuous challenges associated with attaining timely payment. Reviewing denial management strategies on a regular basis may prove a more efficient payment journey. Claim denials are a continuous challenge for the healthcare industry, as providers struggle with write-offs and the resources […]
The U.S. Government Accountability Office is asking the Centers for Medicare and Medicaid Services to gauge the effect that an increase in telehealth utilization is having on the care quality experienced by Medicaid beneficiaries. The GAO cited statistics showing usage continues to rise. GAO culled data from five states – Arizona, California, Maine, Mississippi and […]
During the Delta and Omicron surges, hospitals and health systems faced significant challenges, prompting AHA to ask Congress for additional COVID-19 financial support. The American Hospital Association (AHA) has urged Congress to provide hospitals and health systems with additional COVID-19 financial support, including more Provider Relief Funds and an extension on the Medicare sequester relief. […]
Thanks to new provisions that went into effect for the 2022 calendar year, CMS is no longer necessarily considering “nefarious intent” when determining whether a provider or supplier should be excluded from the Medicare program. The Physician Fee Schedule for the 2022 calendar year is in full effect. The proposals, which were issued in July […]
Not only has Medicaid ensured care access for enrollees during the pandemic, but its coverage of telehealth services has proved a boon to Medicaid providers in California. Increased use of telehealth services by Medicaid beneficiaries in California is leading to positive financial outcomes for providers in the state. CLOSEDLOOP.AI TOPS EPIC, CERNER FOR AI PLATFORM […]
Patient self-service is key for providers to keep pace with the evolution of healthcare consumerism. Catch a flight recently? Odds are, you booked your tickets online. Visited a bank? There’s a good chance you used an ATM. Just think about the last time you went to the grocery store: How long was the self-checkout line? […]
CMS encouraged Medicare Advantage plans to waive prior authorizations during the public health emergency, but AHA urged the agency to make it a requirement instead of a suggestion. The American Hospital Association (AHA) has asked CMS to work with Congress and require Medicare Advantage plans to waive prior authorization processes during the current and future […]
Lawmakers had landed on $15.6 billion as of a Wednesday morning draft but ultimately removed the relief following pushback from Republicans, according to House Speaker Nancy Pelosi. That draft, divided into $10.6 billion for domestic efforts and $5 billion for international support, already fell short of the $22.5 billion requested by the White House just […]
The third batch of Phase 4 COVID-19 Provider Relief Funds will offer $560 million to 4,100 providers who faced revenue loss during the pandemic and serve vulnerable populations. HHS is distributing another $560 million in Provider Relief Fund Phase 4 payments to over 4,100 healthcare providers that have been affected by the COVID-19 pandemic. Provider […]
It’s a well-known fact that the U.S. healthcare system is the most expensive in the world. What may not commonly be as understood is that between 15 to 25 percent of total health care expenditures in the U.S. are attributable to administrative costs, and most of those costs are related to billing activities. With many […]