Claims Processing
Judge also ruled that Humble Surgical Hospital in Humble, Texas, was paying 30 percent kickbacks for facility fees to 103 physicians in exchange for referrals.
Anthem, Cigna have already ended policy of prior authorization for medication assisted treatment for substance use disorders.
Group says it wants to improve timely access to care and reduce administrative burden.
Providers now spend eight minutes on average, and up to 30 minutes on manual tasks like making phone calls, sending faxes and mailing correspondence.
Tool has helped Bellin Health close its reimbursement gap by about $2.2 million in one year.
In lieu of fees, healthcare organizations will pay a percentage of the recovered funds to ERI.
Staffing and productivity issues remain, and with grace periods over, that could spell trouble.
Hospitals that perform joint replacements on older, sicker patients under the program will suffer under reconciliation payment reductions, research suggested.
Coding quality is more important than ever, but other analytics tools are helping hospitals bridge the gap.
Bundles would cover a screening mammogram and other later diagnostic breast imaging services.