Claims Processing
For example, among narrow network plans, median premiums are 10 percent higher for plans with an academic medical center than for those without.
It is important to both health plans and providers that the originator of an Electronic Funds Transfer (EFT) is easily and correctly identified, and that associated Electronic Remittance Advice (ERA) is sent in a timely manner, to eliminate the need for time-consuming follow-up.
Owners are also charged with wire fraud for allegedly filing fraudulent applications for relief relating to the explosion and fire which occurred on the Deepwater Horizon oil rig in April 2010.
After a fractious price battle with Blue Shield, Sutter Health is offering more patients a direct option through its own health plan.
To remain competitive, physician practices must not only provide the best clinical care to their patients, but also optimize the way they manage revenue, making sure they preserve cash flow, limit bad debt and receive full reimbursement for services rendered.
New payment models and technology in healthcare are bringing big changes to the hospital controller job as "following the money" has become more complicated than ever.
A healthy revenue cycle is something for which every business strives, but it is especially important for healthcare organizations in the current industry environment, due to declining reimbursements, shrinking margins and evolving payment models.
If electronic funds transfer via ACH saves healthcare organizations' money and allows staff to focus on secondary billing and improve cash flow, why haven't more providers moved from check payments to EFT via ACH?
Revenue cycle upgrades at U.S. hospitals have been pushed aside, in favor of preparation for the October 2015 ICD-10 transition and the chase for incentives tied to electronic health records, according to a Black Book survey of chief financial officers.
The ICD-10 transition could affect every department at a healthcare system. That means success will depend on organized project management and planning.