Tag: Healthcare RCM

payer-extends-medicare-advantage-footprint-to-reach-5m-seniors

Payer Extends Medicare Advantage Footprint to Reach 5M Seniors

SCAN Health Plan will offer its senior-first Medicare Advantage Plans in 17 markets across three states starting in 2022. SCAN currently provides senior-focused Medicare Advantage plans to 220,000 Californians and aims to reach even more seniors by extending its offerings to Alameda and San Mateo counties. The payer had not offered plans in states other […]
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5-steps-revenue-cycle-succession-planning-success

5 Steps To Revenue Cycle Succession Planning Success

It’s more important than ever for revenue cycle leaders to think seriously about succession planning as baby boomers begin to retire and the revenue cycle increasingly requires more specialized skills, says PeaceHealth’s senior enterprise director of HIM, coding, and CDI. “Everyone’s replaceable,” says Cassi Birnbaum, senior enterprise director of HIM, coding, and CDI at PeaceHealth […]
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2022-ipps-final-rule-boosts-hospital-reimbursement

2022 IPPS Final Rule Boosts Hospital Reimbursement

  On Aug. 2, 2021, the Centers for Medicare and Medicaid Services (CMS) posted the fiscal year (FY) 2022 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule. Effective Oct. 1, the final rule updates Medicare payment policies and quality reporting programs for inpatient and long-term care hospitals […]
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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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4-dos-and-donts-managing-inpatient-observation-status-downgrades

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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Revenue cycle management innovation and disruption

Providers Want Innovation, Disruption for Revenue Cycle Management

In fact, health system leaders in a new report said revenue cycle management was the area in healthcare that has the greatest need for innovation and disruption like AI. Technology can’t solve all of healthcare’s problems, but providers agree that it can definitely improve revenue cycle management. In a recent survey conducted by KLAS and the Center […]
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COVID-19 COding and Billing

4 Critical Attributes of A COVID-19 Billing And Coding Workbook

  Our goal was to develop a single source of truth that is user-friendly, dynamic, and easily accessible,” said Jeannette Wood, vice president of revenue cycle management for Privia Health. A rapidly changing situation like the COVID-19 pandemic calls for a dynamic solution for tracking billing and coding changes for virtual services from different payers […]
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