Survey reveals 5 opportunities to tackle denial prevention and management
In this survey, responses found when organizations devote greater resources to denial management than to denial prevention, their rate of first-pass denials is higher: 13.6% versus 10.9%.
Healthcare Blame Game podcast: Reporters are knee-deep in press releases. Most lack context.
Media veteran Jean Hodges joins Brad to discuss a Washington Post error and the inner workings of the modern newsroom.
As anticipated, the start of the Medicaid unwinding process has taken a toll on coverage
Fears among healthcare policymakers that the end of the COVID-19 public health emergency would sow chaos in Medicaid have been realized, leading the Biden administration to intensify its mitigation efforts. The end of Medicaid continuous-enrollment provisions is affecting the program in many states. In 21 states that had begun the “unwinding” process since April 1,…
Medicare coverage and coding updates: New Alzheimer’s drugs to be covered, but not universally
Note: This article was updated July 6. For drugs manufactured to slow the progression of Alzheimer’s disease, Medicare will offer coverage with certain qualifications, according to a recent CMS announcement. The new policy especially is relevant because the FDA’s first full approval of an Alzheimer’s disease drug may be only a month or so away.…
Out of the back office, into the spotlight: 5 skills revenue cycle leaders need
Healthcare has changed tremendously over the past decade. From increasingly complex payer requirements to growing federal and state regulations to a substantial change in the payer mix (patients are now the second largest payer (27%) behind the federal government (34%), which is mostly Medicare and Medicaid). Today’s revenue cycle is an entirely new animal. What…
Healthcare News of Note: The top 5 reasons U.S. adults say the nation’s healthcare system fails to meet their needs
Nearly three-quarters of adults say the U.S. healthcare system is not meeting their needs in some way, with the length of time to get an appointment the No. 1 reason. The top benefit of using remote patient monitoring during cancer care is to keep the care team up to date on symptoms in between appointments,…
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.
Leveraging extensible technology to create consumer-centric healthcare ecosystems
Implementing new technologies can eliminate tedious tasks and open the door for more impactful work as well as provide patients with easier access to convenient scheduling, registration and billing options. Dive into this roundtable for additional insight on technologies progressing the industry.
Healthcare providers seeing more diagnosis-related group downgrades and ghost denials
Each year, tens of millions of medical claims will be denied by healthcare payers. One executive director led a session with more than a dozen attendees highlighting their experiences with DRG downgrades and lessons learned to help other organizations better measure, manage and successfully appeal these complex denials.