Reimbursement

Ahead of the next open enrollment period, federal regulators are trying to clarify rules for member non-payment and grace periods, but insurers and providers may still have lingering concerns about getting paid.

As payers and employers put pressure on providers to assume more financial risk, providers are struggling to assess the impact of the risk they have already assumed.

Americans across the country may be pleasantly surprised to get a small check from their health plans this summer, but insurers may need to plan better if they want avoid an administrative hassle.

The nation's largest health insurer is making its free mobile app available to everyone, in a bid to move the needle on price transparency.

Medicaid beneficiaries deserve the same access to healthcare services and products as people with commercial insurance or Medicare. But since Medicaid pays doctors and hospitals 27 to 65 percent less than commercial health plans, it makes it awfully difficult for providers to be payer agnostic.

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.

South Nassau Communities Hospital CFO Mark Bogen spoke with Healthcare Finance News about risk, controlling costs and revenue challenges for his Oceanside, N.Y.-based organization.

If all goes according to plan, next year many Arkansas Medicaid beneficiaries will be required to make monthly contributions to so-called Health Independence Accounts.

In the latest battle of the health reform wars, four words could bring down the Affordable Care Act's main insurance expansion policy, depending on which court interpretations gain traction.

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.