IPPS FY23 proposed rule: Tweaks are in store for Medicare’s quality-reporting and pay-for-performance programs
Temporary modifications to two pay-for-performance programs would ensure hospitals don’t face penalties amid the COVID-19 pandemic.
Strategic alternative dispute resolution offers providers key to substantial claim recoveries
To be able to effectively handle disputes over healthcare claims, providers must be well-informed about the two basic types of alternative dispute resolution that can help them achieve favorable results: arbitration and mediation.
A best-practice approach to coding, coding quality and compliance improves reimbursement
Healthcare providers need to ensure they are accurately paid for the care provided, and that starts with timely, correct and consistent coding. This critical revenue cycle process codifies the clinical care performed and documented.
Latest financial metrics for hospitals show reasons for optimism but also persistent challenges
Hospital financial performance partially recovered in March as patient volumes returned to something closer to normal after a significant downturn during the omicron wave.
Anthony Comfort of VisiQuate discusses opportunities for technology in healthcare, both in the clinical space and in revenue cycle
The pandemic pushed healthcare organizations to consider how they were using their technology and where the greatest opportunities lie. This week, Anthony Comfort of VisiQuate discusses some of those opportunities as well as barriers to success. Also in this episode, Brad Brotherton of BKD discusses how his firm stands out and how its merger with DHG will strengthen its services.
OIG calls out issues with denials of payment and services in Medicare Advantage
Medicare Advantage processes related to prior authorization hamper beneficiaries’ access to medically necessary care, according to a new report from the HHS Office of Inspector General.
M&A update: A quiet quarter for hospital deal-making reflects the ongoing consequences of the pandemic
Merger-and-acquisition activity among hospitals and health systems remained well under pre-pandemic levels in Q1 2022.
Tentative deal to provide pandemic funding won’t replenish the COVID-19 Uninsured Program
A bipartisan Senate bill would pay for additional vaccines and therapeutics but wouldn’t restore funding to a program that reimburses providers for furnishing COVID-19-related services to the uninsured.
News Briefs: Biden administration will apply closer scrutiny to healthcare billing practices
A monthly roundup of top news for healthcare finance professionals.
Steve LeFar talks about the implications of care deferrals due to COVID-19
The economic and social impacts from deferred healthcare due to COVID-19 were already a major concern in the pandemic’s first year, portending severe declines in health status for Americans who stopped seeking care for fear of exposure to the coronavirus. In this Q&A, Strata Decision Technology’s Steve Lefar shares insights based on extensive data that tell the story of deferred care across the nation, and the likelihood that providers will see a rising tide of severely ill patients.