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Claims Processing

By Priscilla Holland | 11:34 am | December 05, 2014
A new healthcare electronic funds transfer (EFT) standard went into effect at the beginning of 2014, and many healthcare professionals are reaping the benefits of time and money saved.
By Carl Natale | 11:52 am | December 04, 2014
We keep telling physicians that they may have to survive without reimbursement revenue for six months after the ICD-10 transition in Oct. 1, 2015. But it doesn't have to go down that way if organizations take practical steps.
By Henry Powderly | 10:58 am | December 02, 2014
Viral hashtag campaigns aren't new, but it's not often you see groundswell campaigns about healthcare management topics.
By Carl Natale | 10:31 am | November 26, 2014
Opponents of the transition to ICD-10 coding were successful in attaching a delay to "must-pass" Congressional legislation earlier this year. If ICD-10 proponents are not vigilant, such tactics could work again.
By Jay Hancock, Kaiser Health News | 11:07 am | November 25, 2014
The Obama administration took another step to close what many see as a health-law loophole that allows large employers to offer medical plans without hospital coverage and bars their workers from subsidies to buy their own insurance.
By Henry Powderly | 09:07 am | November 25, 2014
More healthcare providers are outsourcing end-to-end revenue cycle management amid the change to value-based payment models, a new survey shows. Experts predict the market for RCM outsourcing will approach $10 billion by 2016.
By Monte Sandler | 12:52 pm | November 20, 2014
Although it may be tempting to rely on the status quo when it comes to payer payment, opportunities exist to boost collections by shifting key activities upfront and leveraging revenue-driving tools and processes on both the front and back ends of the revenue cycle.
11:40 am | November 17, 2014
The Affordable Care Act's online insurance exchanges launched this weekend with far fewer problems and less fanfare than last year. Many people qualified for federal subsidies that kept their monthly premiums well under $100.
By Chris Nerney | 12:36 pm | November 14, 2014
For many Americans, the ACA open enrollment period offers them an opportunity to have health insurance for the first time. But for hospitals and healthcare organizations, ACA open enrollments create financial and operational challenges.
By Carl Natale | 09:48 am | November 13, 2014
Healthcare providers can expect an increase in medical claim denials after Oct. 1, 2015. But that doesn't have to mean that revenue will be lost.