Claims Processing

Using automation technology to create an engaging payment experience for patients enables providers to see measurable operational and financial improvements including fewer days in accounts receivable, improved cash collections and reduced past-due accounts.

With patients paying more out-of-pocket costs and exchanges increasing the number of plans providers deal with, having financial counselors in a practice may become a necessity.

Even though it has not been determined what impact the health insurance exchanges will have on hospital finances, there are steps hospitals can take to increase the likelihood of positive effects on their revenue cycles.

Medicare announced Friday that it was revising rules intended to prevent the agency from paying twice for the same prescriptions for seniors receiving hospice care. The drug categories in question were identified in a 2012 investigation by the HHS inspector general.

If your modus operandi is to appeal all denied claims, you may want to reconsider because some claims are not worth it.

One of the worst failures of the Affordable Care Act is that, even with subsidies, the premiums and out-of-pocket expenses are unaffordable for far too many people. Unfortunately, a new proposal for catastrophic plans with very high deductibles would make accessing healthcare truly unaffordable for even more people.

Of the states that built their own health insurance exchanges that are now operational, Washington, Kentucky and Minnesota enjoyed some successes that might be replicated.

With Congress delaying the date for ICD-10 compliance to Oct. 1, 2015, you have a great opportunity to re-assess your organization's implementation progress. Make sure these six crucial tasks are on your ICD-10 punch list.

The American Hospital Association is asking federal Medicare leaders to stem the practice of using sample hospital audit data to extrapolate overpayments eligible for recovery. The lack of clarity regarding standards for short patient stays has clouded the issue.

A group of chiropractors went to war with the Blues and it seems they've won, successfully using a novel legal theory that now has lawyers setting their sights on other large insurers.