HFMA Comments on CMS’s EPM IFR
HFMA submitted comments to CMS on EPMs; Cardiac Rehabilitation Incentive Payment Model; and Changes to the CJR; Delay of Effective Date interim final rule
The Move to Office-Based Services Not Yet Showing Impact
Although commercial health plans have tried to equalize payments between hospital and office-based settings, hospital payments still remain higher and share of procedures by site have remained consistent.
Why Health Plans Are Easing Preauthorization
In an attempt to build cooperative working relationships with physicians, some health plans are trying to reduce the burden of preauthorization.
Value-Based Care: Not Just for Primary Care Practices
Donna Levigne of Blue Cross and Blue Shield of Illinois explains why the health plan makes specialty care a priority in value-based care contracting.
Ask the Experts: Telemedicine Payments
Are you offering and billing for telemedicine consults, and are you able to bill for the services when using providers across your system?
Finding a Better Way to Handle Claim Attachments
Standardizing the electronic submission of claims attachments is a hot topic in the industry as stakeholders look for ways to reduce costs.
Ask the Experts: Payer Payments
Are there any benchmarks for how quickly payers should get back to us on claims and denials?
Demand Fuels Expansion of Tiered-Benefit Insurance Products
Stephen T. Swift of BlueCross BlueShield of Western New York writes that collaboration with local healthcare providers spawned a popular tiered-benefit insurance product.
Negotiating Maternity Care Bundles
UTHealth’s maternity bundled payment pilot encountered two challenges: developing fair and consistent quality measures and defining what services would be part of the bundle.
Contracting for Chronic Disease Management
Illinois Gastroenterology Group negotiated a specialty intensive medical home contract with the state’s largest private payer.