Payment Reimbursement and Managed Care

Holliday & Associates: Comprehensive Charge Management Software

A charge management company discusses how it helps clients successfully manage charge processes, comply with changing coding and regulatory requirements, eliminate charge-related compliance risks and ensure accurate and appropriate reimbursement.

HFMA October 1, 2019

Medicare advisers meeting among next week’s key industry events

Healthcare finance policy events for the week of Sept. 30.

Rich Daly September 30, 2019

Analysis: Tennessee proposes an overhaul to funding of its Medicaid program

HFMA's Chad Mulvany reviews Tennessee’s proposal to overhaul funding of its Medicaid program and shares why CMS is likely to reject it.

Chad Mulvany, FHFMA September 30, 2019

2 approaches illustrate best practices in digital patient engagement

Two health plans shared the ways they’ve improved digital engagement with both patients and providers.

Rich Daly September 26, 2019

Verma to insurers: The public is ‘frustrated with you’

Seema Verma, administrator of CMS, says health plans need to become much more innovative, or they will be eliminated due to political pressure stemming from the public’s frustration.

Rich Daly September 26, 2019

Court tosses $380 million site-neutral payment cut

A federal judge rejected a large 2019 payment cut for many hospital outpatient departments.

Rich Daly September 24, 2019

Analysis: Site-neutral payment ruling favors hospitals for now

A Sept. 17 ruling by a U.S. District Judge favored hospitals by overturning the CMS rule that cut Medicare payments for E&M visits in certain hospital-based settings.

Chad Mulvany, FHFMA September 24, 2019

Do the Democratic candidates for president see a role for private insurance?

Healthcare is a major defining issue in the campaigns of the Democratic candidates for president, but their positions differ, particularly with respect to private insurance.

Gail R Wilensky, PhD September 20, 2019

Only a tiny share of hospital revenue is risk-based: Moody’s

Just 1.9% of net patient revenue for not-for-profit (NFP) hospitals in 2018 came from risk-based payment, according to a credit-rating agency.

Rich Daly September 19, 2019

Proposed mandatory models should be voluntary or delayed, providers say

The latest proposed mandatory Medicare payment models drew concerns from many providers, including hospitals that cited the potential for adverse financial impacts.

Rich Daly September 18, 2019
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