More than half of economists agree that the U.S. economy is headed for a downturn. Contrary to popular belief, the healthcare sector has never been recession-proof. Reports indicate that the healthcare industry is affected later in a recession and has a longer recovery period. Compared to other healthcare facilities, like hospitals and emergency rooms, independent […]
What you need to know to avoid claim denials and to maximize practice revenue Despite your best efforts to follow billing guidelines, payers still deny your claims. Or in some cases, they pay you and then take the money back. Experts say you can’t ever eliminate denials and post-payment recoupment entirely, but you can reduce […]
Of the 12 states that have not expanded their Medicaid programs, four have taken legal, legislative, and/or budgetary actions this year with varying results. The Kaiser Family Foundation (KFF) has updated its state Medicaid expansion tracker, highlighting 2022 activity through July. The following summarizes activity in both expansion and non-expansion states. In January 2022, Georgia […]
Can you survive an OIG Audit? When the Public Health Emergency (PHE) was extended for the 10th time on July 15, 2022, continuing the PHE through October 13, 2022, so were many waivers under the 1135 CARES Act of March 20, 2020. However, if you are not keeping up with the commercial payers and the […]
“This will not only lower the cost of prescription drugs and health care for families, it will reduce the deficit and help fight inflation.” — President Biden, in a statement on health-care provisions in pending Senate bill, July 15 After months of negotiations, the president’s expansive “Build Back Better” plan has shrunk to a handful […]
Open communication, payment options, and understanding are all key to improving patient collections in a consumer-oriented healthcare landscape. The rising cost of healthcare in the United States has left consumers feeling lost and overwhelmed. High deductible healthcare plans, co-pays, and out-of-pocket medical expenses have all contributed the emergence of healthcare consumerism, which is the pursuit […]
Twenty percent of adults said they or a family member has received a surprise medical bill since the No Surprises Act went into effect on Jan. 1 according to a Morning Consultant report released July 7. Morning Consultant conducted a survey among a representative sample of 2,210 U.S. adults between June 22-24, according to the […]
Effective January 1, 2022, new billing protections went into effect that have the goal of providing greater protections for patients against surprise medical bills. The Departments of Health and Human Services, Labor, and Treasury, and the Office of Personnel Management (collectively, the Departments) implemented these additional protections that are part of the No Surprises Act […]
Most claims payments are now electronic, but providers can still realize millions in cost savings and reduce burden through true claims payment optimization. Claim payment is one of the most important steps in the claims management process. Healthcare providers rely on this step to keep their operations running smoothly for patients. But while claim […]