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 payment […]
It was another tumultuous year for the revenue cycle, from the slow burn of price transparency and the fight over surprise billing, to the renewed focus on the workforce, not to mention the continuing COVID-19 pandemic. Here are three issues that defined 2021 for the revenue cycle: PRICE TRANSPARENCY’S SLOW BURN For all the build-up […]
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 […]
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 offerings […]
Taya Moheiser, CMPE, CMOM, owner of ITS Healthcare, and Kem Tolliver, CMPE, CPC, CMOM, president of Medical Revenue Cycle Specialists to share the top trends they’re following right now. KEY TAKEAWAYS Mental health billing will continue to evolve. Billing directly to Medicare for physician assistants will take center stage. Be sure to educate your revenue […]
The news coincided with the sudden worldwide emergence of the new omicron COVID-19 variant. An influx of cash couldn’t have come at a better time for the nation’s rural healthcare system. The U.S. Department of Health and Human Services (HHS) last week announced that the Health Resources and Services Administration (HRSA) has begun distributing […]
If you’re leaning toward pausing your vaccination requirement process, be ready to crank it back up on a dime, legal experts stress. After the Biden administration issued two COVID-19 vaccination regulations on Nov. 5 — one from the Centers for Medicare & Medicaid Services and one from the Occupational Safety and Health Administration — states […]
Mississippi’s Medicaid program ranks poorly for its access to and quality of care, but Medicaid expansion could increase healthcare coverage along with lowering state Medicaid spending. Mississippi could achieve lower state Medicaid spending over the course of five years by expanding its Medicaid program with the American Rescue Plan boost to federal matching, a Manatt […]
The number of beneficiaries in traditional Medicare using telehealth exploded 63-fold in 2020 from 840,000 in 2019 to nearly 52.7 million, a new study found. The study, released Friday (PDF) by the Department of Health and Human Services (HHS), comes as advocates are pressing to make key flexibilities the federal government enabled at the start […]
Medicare Advantage plans hold up their end of the contract with CMS, and provide, at a minimum, a fair reimbursement for services delivered. The physician advisor is a fast-growing specialty that has evolved into so much more than someone who performs endless chart reviews for observation status determinations, medical necessity reviews, peer-to-peer conversations with payors, […]