Your To-Do List When Health Plan Contracts Change
Six steps can help revenue cycle leaders manage health plan changes effectively.
Exemptions to Anthem’s ED Policy
Anthem will not deny an ED claim based on the prudent layperson standard if certain conditions apply.
Ask the Experts: Credit Balances
How do other Florida hospitals initiate and work credit balances?
HFMA Regulatory Overview: 2019 Medicare Advantage Final Rule
This presentation provides an overview of CMS's 2019 Medicare Advantage program final rule, published in the April 16, 2018, Federal Register.
Ask the Experts: Cost Sharing Programs
I am looking for more information about how to manage patients covered by cost sharing programs.
BPCI Advanced Improves Care, Physician Alignment, and Revenue
A healthcare thought leader explains how hospitals can generate savings, improve clinical care, and foster physician alignment by participating in BPCI Advanced.
The Impact of Accountable Care on the Revenue Cycle
Implementing value-based payment models requires changes to revenue cycle processes, including a greater focus on making sure claims reflect all services performed.
Developing a Specialty Medical Home Contract
University of Pittsburgh Medical Center gastroenterologists have teamed with UPMC Health Plan to develop a specialty medical home contract for patients with inflammatory bowel disease.
Video: Tips for Secure Medical Record Transmission to Payers
Common mistakes are not using security options to send records and not tracking what data or claims are sent.
Advancing Contracting Strategy in a Complex Environment
Providers should approach their contracting portfolios with the intent to drive value creation across all payers and products. Likely challenges will be narrow networks and tiering and the transition from fee-for-service to value-based care.