Tag: Revenue Cycle Management

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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cms-asks-medicare-advantage-plans-to-relax-prior-authorizations

CMS Asks Medicare Advantage Plans to Relax Prior Authorizations

  The agency emphasized relaxing prior authorizations that could impact transferrals between general acute-care hospitals and longer-term care facilities. CMS has requested that Medicare Advantage organizations relax or waive prior authorizations due to the impact of the coronavirus Delta variant. “The ability of hospitals to transfer patients to appropriate levels of care without unnecessary delays […]
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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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cms-seeks-to-improve-healthcare-outcomes-and-drive-down-costs

CMS Seeks to Improve Healthcare Outcomes and Drive Down Costs

CMS’ proposed actions are intended to increase price transparency, access to care, patient safety, positive healthcare outcomes, and health equity. On July 19, 2021, the Centers for Medicare & Medicaid Services (CMS) announced new proposed actions to address the health equity gap, decrease mounting healthcare costs, and increase medical accessibility and patient quality of care. […]
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hospital-volumes-climbing-2019-levels

Hospital Volumes Climbing To 2019 Levels

  Providers also said they expect patient demand to exceed capacity in psychiatry, orthopedic surgery, cardiology, and gastroenterology in the next six months. Hospital volumes in the United States are approaching 2019 levels, finds new research from McKinsey & Company The firm surveyed leaders at 100 private sector hospitals across the United States in late […]
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Battling EHR dissatisfaction with 4 personalization techniques

  Personalizing your EHR is a proven best practice for new implementations and major system upgrades. These four new approaches boost physician satisfaction and improve EHR usability. When EHRs first emerged 20 years ago, system vendors pushed for standardization. Consistency was considered the only pragmatic way to support end users and enterprise-wide systems. EHR customization […]
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unitedhealthcare-loses-medicare-advantage-overpayment-suit.

UnitedHealthcare loses Medicare Advantage overpayment suit

Dive Brief: A federal appeals court has ruled against UnitedHealthcare, the biggest private payer in the U.S., and reversed a 2018 decision overturning Medicare’s overpayment rule requiring insurers to refund reimbursement to CMS within 60 days if they learn a diagnosis lacks medical record support. UnitedHealthcare argued in court in November the overpayment rule was […]
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