Claims Processing

S&P Dow Jones Indices has launched a new indicator that measures claims data from 33 health insurance companies and other organizations to calculate the growth in commercial healthcare costs.

The ICD-10 transition is a wonderful opportunity for collaboration. More accurately, collaboration is a necessity.

The growth rate of healthcare spending rose 4 percent in 2012, slightly lower than the previous year, but with more dollars spent on outpatient care and out-of-pocket expenses, according to the Health Care Cost Institute.

Managing denials is a challenging prospect for providers, but experts say there are steps to make the process more efficient and more likely to be successful.

The Centers for Medicare & Medicaid Services issued a final rule on Medicaid payments to disproportionate share hospitals last week, cutting approximately $1.1 billion from the program over the next two fiscal years.

A recently unsealed lawsuit alleges that Vanderbilt Medical Center has been systematically billing Medicare fraudulent charges for at least a decade.

One thing that strikes fear into the hearts of many physicians is the impending switch from ICD-9 to ICD-10, but experts say preparation and planning should keep their accounts receivable from stalling altogether.

According to a revenue cycle management study released by market researcher Black Book, 72 percent of physician practices expect declining to negative profitability next year because of underutilized or inefficient billing technology.

With implementation of the Affordable Care Act fast approaching, the eligibility process could be queuing up for an overhaul.

The Centers for Medicare & Medicaid Services has recommended that hospitals start testing for ICD-10 in 2013, but so far, many have not heeded that recommendation. That mistake could ultimately hit hospitals in the wallet.