(Updated 2) Texas court again backs providers in No Surprises Act independent dispute resolution litigation
A physician association continues to roil the No Surprises Act’s arbitration process through successful litigation. For the second time in a year, the Texas Medical Association (TMA) prevailed in court after arguing that regulations governing the independent dispute resolution (IDR) process do not comply with legislative intent. Barring a successful appeal, the Feb. 6 ruling…
In new final rule, CMS looks to claw back billions in overpayments to Medicare Advantage health plans
CMS has confirmed a new approach to its auditing of payments directed to Medicare Advantage health plans, but the agency says the regulatory burden on providers should not increase. A newly published final rule on risk adjustment data validation (RADV) establishes that CMS will use an extrapolation methodology to recoup overpayments to MA plans beginning…
How to meet your patients’ communication preferences and improve your bottom line
In this HFMA executive roundtable, seven health system leaders share their efforts to effectively engage patients and the lessons they have learned along the way.
Professional Credit eases the collections process for both staff and healthcare consumers
Debt collections are often the last communication touch point a patient has, and health systems should ensure their business partner is representing the organization in the best possible manner. See how one company eases the collections process for staff and consumers.
Healthcare News of Note: 100 hospitals receive funding for new physician residency slots to boost healthcare access
CMS distributed 200 Medicare-funded physician residency slots to 100 hospitals, aiming to bolster healthcare access in areas with a shortage of qualified professionals. Overall cancer mortality has dropped 33% since 1991, averting an estimated 3.8 million cancer deaths, according to the American Cancer Society’s latest report. Patients’ ratings of specialist care were markedly higher when…
How healthcare providers can break down barriers to effective data governance
Promoting improved data governance in the hospital and health system sector has become a just cause of sorts for Randy Albert, who serves as vice president of finance – operations and analytics at Maine-based Northern Light Health and is a member of HFMA’s Northern New England Chapter. “This is a topic that I’m incredibly passionate…
News Briefs: 2023 brings a steep fee hike for No Surprises Act arbitration cases
The No Surprises Act’s independent dispute resolution (IDR) process has become more expensive for healthcare stakeholders. For the new year, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration increased from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and…
Hospitals have options for effectively managing complicated reimbursements
How can health systems and patients both win when it comes to payment? Read this article to learn how hospitals can maximize collections and get paid for provided services on top of how patients can identify source of payment that is not out of pocket.
Key points to know in recently proposed rules for Medicare Advantage and the ACA marketplaces
A proposed rule for health plans in Medicare Advantage has provisions designed to stem overreach in prior authorization processes.
How to use analytics and automation to build an intelligent A/R strategy
Health systems seeking to improve their accounts receivable function are turning to machine learning and AI to streamline patient interactions in ways that benefit the organizations and their patients. Read the challenges and benefits of using automation health system executives discuss in this roundtable.