Tag: Healthcare RCM Outsourcing

RCM Pain Points

Addressing Common Pain Points in RCM And How Outsourcing Alleviate It?

Revenue cycle management (RCM) is an intricate and critical aspect of the healthcare industry, encompassing the entire process from patient registration to reimbursement. However, RCM processes often face challenges, leading to pain points that can hinder efficiency, increase costs, and negatively impact patient satisfaction. Outsourcing Revenue cycle management services offers a viable solution to alleviate […]
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Why Medicare’s trustees say the physician pay system is unsustainable

Medicare’s trustees have issued a report (PDF) that reckons with the consequences that patients could face as a result of the physician payment system’s long-term unsustainability. Your Powerful Ally The AMA helps physicians build a better future for medicine, advocating in the courts and on the Hill to remove obstacles to patient care and confront […]
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How Medicare Out-of-Pocket Healthcare Spending Cap May Impact Beneficiaries

How Medicare Out-of-Pocket Healthcare Spending Cap May Impact Beneficiaries

A Medicare out-of-pocket healthcare spending cap could halve out-of-pocket spending for beneficiaries, but could boost overall traditional Medicare spending. By implementing a $5,000 spending cap in traditional Medicare, policymakers might be able to halve out-of-pocket healthcare spending for high-spending Medicare beneficiaries, but they risk an increase in overall Medicare spending, a study from Urban Institute […]
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No Surprises Act May Have Blocked 2M Surprise Billing Claims | AllZone Management Services Inc.

Healthcare spending could drop $11.4B next year if ACA premium subsidies expire, research finds

Healthcare spending could drop by more than $11.4 billion next year if enhanced premium tax credits enacted in the American Rescue Plan expire, new research finds. Hospital spending would decline by $3.8 billion, while spending on physician practice services would drop by $1.3 billion, according to a report from the Robert Wood Johnson Foundation and […]
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AMA says health insurance industry failing on prior auth reform

Survey shows little progress after four years of promises The American Medical Association says that despite insurance industry promises to reform and improve prior authorizations, little effort has been made to do so. This comes despite evidence that insurer-imposed authorizations can be hazardous and burdensome to patient-centered care. In January 2018, the AMA and other […]
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Healthcare Finance Leaders Facing Revenue Cycle Workforce Shortages

More than 400 healthcare finance leaders reported having revenue cycle workforce shortages, with almost 20 percent seeing 30 or more vacancies. Healthcare finance leaders are experiencing revenue cycle workforce shortages, with one in four reporting that they need to hire more than 20 employees to fully staff their department, according to a survey commissioned by […]
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medicare-advantage-prior-authorizations-are-often-unnecessarily-denied

Medicare advantage prior authorizations are often unnecessarily denied

  A report by the Office of Inspector General (OIG) raises concerns about organizations prioritizing profits over patient access to care. Medicare Advantage organizations (MAOs) often delay or deny services for medically necessary care, even when prior authorization requests meet coverage rules, according to a report by the OIG. A concern with the Medicare Advantage […]
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CMS considers use of covid-19 claims for fy 2023 rate setting

CMS released the fiscal year (FY) 2023 inpatient prospective payment system proposed rule with proposals for new calculations for FY 2023 rate setting. Although CMS is proposing to use FY 2021 data for FY 2023 Medicare Severity Diagnosis-Related Groups (MS-DRG) rate setting, the agency wants a modified methodology to account for the historical and potential […]
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Key Advantages of Medicare Advantage Plans Versus FFS Medicare

Medicare Advantage plans draw a more diverse beneficiary population and can result in lower healthcare spending for low-income beneficiaries. Medicare Advantage plans may provide better access to care and lower healthcare spending for enrollees, compared to fee-for-service Medicare, according to a study from ATI Advisory conducted on behalf of Better Medicare Alliance (BMA). “Medicare Advantage […]
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