Tag: RCM Companies.

ama-prior-authorization-creates-physician-burden-patient-care-delays

AMA: Prior Authorization Creates Physician Burden, Patient Care Delays

Although health plans aim to promote value-based care with prior authorization requirements, providers and patients may experience negative repercussions from the process. Prior authorization negatively impacted patients and providers alike by leading to care delays for patients and creating administrative burden for physicians, according to a survey from the American Medical Association (AMA). Health plans […]
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ahip-warns-proposed-aca-exchange-rule-could-threaten-markets-growing-stability

AHIP warns proposed ACA exchange rule could threaten market’s growing stability

  AHIP, the top lobbying organization for commercial insurers, is warning the feds that provisions in its proposed rule governing the Affordable Care Act’s exchanges for 2023 could “undermine” the growing stability there. For instance, the group says in comments (PDF) submitted late Thursday that potential changes to requirements for essential health benefits would limit […]
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cyber-technology-for-medicare-audits

Cyber Technology for Medicare Audits

This is what providers can expect in 2022 in the form of new technology audits. During 2022, healthcare providers will see more options to exploit cyber technologies designed to aid them in management of Medicare audits. Below we review the informational challenges of managing an audit, and then turn to the types of cyber solutions […]
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cms-updates-affordable-care-act-public-payer-enrollment-numbers

CMS Updates Affordable Care Act, Public Payer Enrollment Numbers

Affordable Care Act enrollment for 2022 and public payer enrollment midway through 2021 saw some record-breaking surges. In 2020 and 2021, public payer and Affordable Care Act marketplaces experienced major disruptions and changes that continue to have ripple effects. The year that the pandemic struck, Medicaid and CHIP enrollment escalated for the first time in […]
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medicare-advantage-consolidation-drove-healthcare-insurer-trends-2021

Medicare Advantage, consolidation drove healthcare insurer trends in 2021

  COVID-19 continued to affect the industry, which has plowed forward with expanded offerings, digital transformation and other bold moves. It was difficult to predict trend lines for the payer and health insurance industry in 2021, largely because of persistent uncertainties due to the COVID-19 pandemic. Consumer behavior has become more unpredictable, care models and […]
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