Claims Processing

These key performance indicators reveal a lot about whether turning to a third party will prove to be a worthwhile investment and yield an adequate return.

A deposition reveals former medical director never looked at patient medical records, but Aetna says correct guidelines were followed.

While MVA and workers' compensation claims are only a small percentage of a healthcare organization's total claims, they can amount to millions of dollars in annual revenue for many hospitals and secure higher reimbursement rates than commercial insurance.

Revenue cycle collections has as much to do with insurer inconsistencies as with internal operations, report says.

Some would pay as much as $1,000 for genomic sequencing offered through employer health plans.

Hospitals wrote off 90 percent more denials than six years ago, The Advisory Board found, a difference of $3.5 million for a median 350-bed hospital.

The following are 10 ways providers can improve self-pay collection and communication at all three stages of patient contact: pre-service, point-of-service, and post-service.

Its new Insurance Checker feature seeks to ease a common pain-point: deciphering, understanding and verifying health insurance.

Total costs of Kymriah and 21 similar drugs in development - CAR T-cell therapies - will reach $1 million or more per patient, according to leading cancer experts.

St. Francis Hospital used web-bots to replace manual queries to payers, yielding instant transactions that immediately find information providers need.