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.
Seeking to phase out Medicare DSH payments, MedPAC outlines potential changes to reimbursement for safety net providers
Revamped formulas for hospitals and physicians would be designed to better target payments to providers that treat larger shares of low-income Medicare beneficiaries.
Beyond automation: Fulfilling your New Year’s resolution for a more efficient revenue cycle
Jonathan Wiik, vice president of health insights at FinThrive, discusses how provider organizations continue to struggle with denials in a time when staff is hard to find.
Labor costs and other concerns dampen the outlook for not-for-profit hospitals this year
Insights from a leading credit-rating agency illustrate the scope of the financial challenges facing not-for-profit hospitals in 2023.
4 tips for simplifying prior authorizations
Healthcare spending in the U.S. has reached what many consider to be unsustainable levels. While spending in other developed nations averaged 8.8% of GDP in 2019, it was nearly double that in the U.S. at 16.8%. One of the major contributors to this spending is administrative waste, which accounts for up to 30% of our…
Medicare contractors should more closely examine providers’ bad debt claims, HHS watchdog says
Medicare administrative contractors (MACs) soon could apply more scrutiny to providers’ reported bad debts if CMS implements recommendations from the HHS Office of Inspector General (OIG). OIG in December issued a report in which it examined bad-debt reimbursement claims on Medicare cost reports spanning 2016 through 2018 for 67 randomly selected providers (including 29 hospitals). In those…
For the No Surprises Act arbitration process, 2023 brings a steep fee hike and continuing litigation
The No Surprises Act’s independent dispute resolution (IDR) process is about to become more expensive for healthcare stakeholders. In 2023, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration will increase from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and Insurance…