How LifePoint Health revamped its revenue cycle
Executives for the non-urban focused health system wanted to get all of its hospitals using a single revenue cycle management approach.
Simplifying the revenue cycle while building resilience
“Several senior financial leaders discuss their organizations’ revenue cycle management (RCM) optimization initiatives, focusing on a variety of strategies, including eligibility checks, denials prevention programs and automation.”
Revenue Cycle Insights: February 2022
This month's issue leads off with the news that the federal government is taking a look at provider billing in the COVID era through audits by the Office of Inspector General.
Coverage denials based on medical necessity are far more likely to arise from Medicare FFS rules than from MA plan policies
Coverage rules stemming from Medicare national and local determinations were the most likely cause of claim denials in one Medicare Advantage plan.
HFMA’s new Premium Facilitated Learning courses combine self-directed study with facilitator feedback and time for peer problem solving
Learn more about HFMA’s Premium Facilitated Learning — a new line of courses — that combine self-directed study with expert facilitation in this Q&A with HFMA’s Sue Spear, director of Digital Learning and Todd Nelson, director of Partner Relationships.
How to unleash the true value of your remote reps using workforce management
A data-driven management approach to revenue cycle that empowers your staff could effect sweeping change for improved long-term financial health.
Hospitals and Congress propose improvements to prior authorization processes in Medicare Advantage
The American Hospital Association says pending regulations that would affect prior authorization should be expanded to include Medicare Advantage.
Healthcare News of Note: National index shows denials are up 11% since the onset of COVID-19
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Denials are up since the onset of COVID-19, nonprofit hospitals’ community investing falls short, and pediatric clinicians use the EHR less than other clinicians.
UnitedHealthcare reverses course on new approach to emergency department claims, but perhaps only temporarily
UHC had announced this week that it would evaluate claims starting July 1 to determine whether ED visits were for emergent or nonemergent events.
Looming UnitedHealthcare policy on coverage of emergency department care draws opposition from hospitals, physicians
In a move strongly opposed by provider associations, UnitedHealthcare soon will start denying coverage of ED care that it deems to have been nonemergent.