Report quantifies the financial impact of certain health plan business practices on providers
As hospitals seek to regain their financial footing coming out of the pandemic, they may find themselves stymied by commercial payer policies, according to a new report. “It’s true that commercial payers might generate more net revenue than public payers on a per-case basis,” Crowe states in a report it recently published. “But at what…
How healthcare organizations navigate claims processing
View the results of a survey about claims processing and revenue cycle performance conducted with more than 625 healthcare leaders.
The impact of claims denials on the financial health of healthcare
While their hospitals and healthcare centers have long had to deal with claims denials, the number of denied claims continues to rise and payers are showing little inclination to help solve the problem, according to several roundtable participants.
For the No Surprises Act arbitration process, 2023 brings a steep fee hike and continuing litigation
The No Surprises Act’s independent dispute resolution (IDR) process is about to become more expensive for healthcare stakeholders. In 2023, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration will increase from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and Insurance…
Clinical audits and denials impact 3% or more of NPR being held in reserve
This pulse survey shows how healthcare organizations are currently tracking health system’s audits and denials from government and commercial payers.
Clinical Audits and Denials Research Report
HFMA, with sponsorship by MRO, surveyed 317 healthcare revenue cycle, finance and accounting executives to understand how organizations are handling claim audits, risk exposure, claim tracking, and reserves.
Healthcare News of Note: UnitedHealth Group can proceed with Change Healthcare purchase after a favorable decision in an antitrust case
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: UnitedHealth Group cleared to acquire Change Healthcare, standard patient satisfaction surveys need to address DEI issues, and homebound older adults contribute to higher levels of Medicare spending.
MRA|Revecore’s AcciClaim boosts reimbursements for accident claims
A leading claims management company talks about how it streamlines the complex billing and follow-up activities associated with motor vehicle and workers’ compensation accident claims, driving revenue into healthcare organizations.
Improve cash flow and cost of reworking denials with the efficientC claim scrubber technology
In five years’ time, denial claims have shot up 20%. Learn about a decision support and claims management technology platform that stops claims before they get denied.
Final rule appears to give a boost to providers in No Surprises Act arbitration cases
A new final rule codifies updated criteria for deciding arbitration cases under the No Surprises Act, with providers potentially coming out ahead relative to last year’s interim final rule.