Prior Authorization and Interoperability for Medicare Advantage, Medicaid, CHIP, and QHPs Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule designed to improve the electronic exchange of health care data and streamline prior authorization processes, while continuing to encourage interoperability in the healthcare market.
Survey: Understanding and mitigating risk in compensating physicians
Important learnings from a February 2020 HFMA-conducted survey about physician compensation, where healthcare organization leaders offer insights on the complexities of the process.
How to automate revenue cycle operations to improve revenue and reduce resource dependency
Even with an increased focus on automation in the industry, too many revenue cycle operational processes remain highly manual and resource intensive. This is especially true for mid-cycle processes. Manual data entry, such as coding, leaves significant room for error and takes longer to complete, leading to slower reimbursement and ultimately impacting the bottom line. Automation…
New federal rule aims to eventually ease prior authorization processes
CMS is seeking to improve the prior authorization process in government programs such as Medicare Advantage (MA) and Medicaid, although the core provisions would not begin until 2026. The agency this week updated a Trump administration proposed rule with new proposals to “improve patient and provider access to health information and streamline processes related to prior authorization…
Cracking the Code on Physician Practice Performance
In many respects, today’s physician practice operating model isn’t working. Not only is there wide variation in patient care and operations management across medical groups, but there are numerous challenges with which practices continue to struggle, such as limited resources, operational complexity, physician burnout, patient satisfaction, and rising costs. Taken together, these multifaceted dynamics can…
Cloudmed, an R1 company, helps health systems get paid for the care they provide
Using one company’s AI platform, health systems will find uncovered funds that can be used to hire essential practitioners, build new facilities and fund outreach programs.
Gail Wilensky: Cybersecurity in healthcare has emerged as a national priority
The threat of cyberattacks on healthcare facilities has taken on a new immediacy with the increased use of electronic communication during the pandemic. The issue of cybersecurity has rapidly risen to become a predominant concern for healthcare organizations, with profound implications for the nation as a whole.a The issue is particularly concerning where cyberattacks can…
Optimize the cost effectiveness of health through prioritizing the patient experience
Read up on various strategies from several health system executives, including taking full advantage of EHR, reducing expenses, improving patient experience and so forth.
Conserving capital expenses through clinical asset reallocation
Michelle Brandt is vice president of physician, ambulatory contracting & credentialing at MedStar Health in Columbia, Maryland About TRIMEDX As an industry-leading, independent clinical asset management company, TRIMEDX helps healthcare providers transform their clinical assets into strategic tools, driving reductions in operational expenses, optimizing clinical asset capital spend, maximizing resources for patient care, and delivering improved safety & protection. This published piece is provided solely for informational purposes. HFMA does not endorse the published material or warrant or guarantee its accuracy. The statements and opinions by participants are those of the participants and not those of HFMA. References to commercial manufacturers, vendors, products, or services that may appear do not constitute endorsements by HFMA.
Revenue cycle technology budgets rise to meet need for automation, AI and robotics, says new survey
See five areas where there is room for additional automation according to respondents in a recent survey. Also read about using AI in the revenue cycle and the benefits it brings hospitals and healthcare systems such as dealing with staffing challenges, dwindling margins and increased denial rates.