Revenue Cycle Management
Although it may be tempting to rely on the status quo when it comes to payer payment, opportunities exist to boost collections by shifting key activities upfront and leveraging revenue-driving tools and processes on both the front and back ends of the revenue cycle.
Changing eligibility standards could purge a million or more beneficiaries from Medicaid rolls in California. A lawsuit seeks to stop the state from canceling coverage for Medi-Cal recipients who haven't been properly notified.
The Affordable Care Act is injecting billions upon billions of dollars to provide Medicaid to previously uninsured people. More money should help healthcare providers' finances, not hurt them. So what's going on?
As more new patients come into the healthcare system, savvy providers are seeing opportunities to develop better relationships with the hope that it will translate to greater bill collection success.
For many Americans, the ACA open enrollment period offers them an opportunity to have health insurance for the first time. But for hospitals and healthcare organizations, ACA open enrollments create financial and operational challenges.
Healthcare providers can expect an increase in medical claim denials after Oct. 1, 2015. But that doesn't have to mean that revenue will be lost.
Bon Secours Health System wants to ensure discharged patients get the care and attention they need without being unnecessarily readmitted to the hospital. To that end, they're launching a new population health and care management program.
Does your organization have a planned response to virtual card claims payments by patients, and do you know your rights under the Affordable Care Act to a less expensive form of claims payment? It is important for providers to understand their rights under HIPAA and the ACA and make an educated decision.
Although CMS paused the RAC audit program in March, hospitals must remain vigilant. The agency has promised a new round of recovery auditor contracts will be awarded before the end of 2014.
Hospitals dependent on Medicaid disproportionate share allocations must discover new financing models for low-income patients, or else lobby their state governments to make policy changes.