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Claims Processing

By Mary Mosquera | 01:00 am | July 25, 2013
Some of the most challenging aspects for payers to prepare for operating on the exchanges have to with the basics, such as products, rates and service models.
By Kevin Fuller | 11:14 am | July 24, 2013
Real-time claims processing can result in financial benefits, so healthcare technophobes need to get on board.
By Kelsey Brimmer | 11:25 am | July 23, 2013
If the states not expanding Medicaid under the Affordable Care Act stay with their decision, those state governments will collectively spend $1 billion more on uncompensated care in 2016 than they would have had they expanded Medicaid, says a recent RAND Corporation study.
By Kelsey Brimmer | 10:52 am | July 11, 2013
The Centers for Medicare & Medicaid Services' 2014 proposed rules for the hospital outpatient prospective system, released earlier this week, offer payment increases and "packaging" of services.
By Mary Mosquera | 09:40 am | July 09, 2013
Geographic variations in Medicare medical treatment costs can differ among episodes of care for certain conditions and not only across but within regions, according to a new study from the Center for Studying Health System Change.
By Mary Mosquera | 09:11 am | June 19, 2013
Patients are responsible for nearly one-quarter of their medical bill on average through the cost of co-pays, deductibles and co-insurance, according to the latest National Health Insurer Report Card from the American Medical Association (AMA).
By Kelsey Brimmer | 01:33 pm | June 18, 2013
With so many reimbursement considerations to think about with the transition to ICD-10, such as reduced cash flow and an increase in denials and audits, the best defense for healthcare systems is to know what to expect and begin preparing for the changes now.
By Mary Mosquera | 07:07 pm | June 17, 2013
MedPAC has found that hospitals with a large portion of low-income patients also have higher readmission rates, and, therefore, higher penalties under Medicare's hospital readmissions reduction program. That imbalance was one of the reasons that MedPAC, in its annual June report to Congress, has recommended that Medicare modify its readmissions reduction policy.
By Stephanie Bouchard | 03:10 pm | June 17, 2013
The Healthcare Financial Management Association released on Sunday, the opening day of its annual conference, a draft of new best practices for patient financial interactions.
By Stephanie Bouchard | 02:27 pm | June 17, 2013
Selecting the "right" collection agency partner is critical for providers, a panel of experts said Monday at the Healthcare Financial Management Association's ANI 2013 conference in Orlando, Fla.