Claims Processing

One of the biggest challenges hospitals face is getting paid. There's a long list of headaches contributing to a very challenging landscape in the medical billing world. Michele Hilton, general manager of medical billing services, ADP AdvancedMD, offers a little painkiller cocktail to preemptively strike against the headaches of medical billing.

The Medicare Payment Advisory Commission (MedPAC) on Friday debated how to change the payment method for chronically critically ill patients in acute care and long-term care hospitals so they are more accurate and based on patient needs.

According to a recent study published in the American Journal of Managed Care (AJMC), researchers from America's Health Insurance Plans (AHIP) found that from 2008 to 2010 inpatient hospital prices increased by 8.2 percent each year with a wide variation in price levels and growth rates from state to state.

Providers will drive the overhaul of the health system when they focus on the value of their care delivery to produce measurably better outcomes for patients.

Any patient will tell you that a good bedside manner is just as important as solid medical credentials. As far as Dr. Hubert Fu is concerned, that extends as much to the practice of debt collection as it does to the practice of medicine and that's why he started Debt M.D.

Even though 2 percent reductions are scheduled to hit Medicare payments due to sequestration cuts beginning on April 1, a recent Standard & Poor's (S&P) report said the futures outlook for for-profit hospitals is stable.

In an education session Monday at HIMSS13 titled "How Hospitals Improve Their Bottom Line and Improve Relationships with Uninsureds," two people on the front lines showcased an innovative, IT-enabled approach to "transition from seeing these patients as a burden," and toward a way to better engage them in financing their care.

With the Affordable Care Act's (ACA) expansion of insurance coverage expected to increase the need for primary care services -- requiring an estimated additional 7,200 primary care providers -- 7 million Americans could likely face a primary care physician shortage after 2014.

The Department of Health and Human Services has published final rules for essential health benefits and several other policies that clarify rules on mental health benefits.

The Centers for Medicare & Medicaid Services (CMS) has proposed several dozen regulatory updates to Medicare Advantage and Part D prescription drug plans, covering cost sharing, minimum loss ratios, risk adjustment, payment methodologies and other policies.