RemitConnect® helps healthcare organizations automate manual posting and reconciliation processes
This HFMA Peer Review Spotlight explores the benefits of CommerceHealthcare's RemitConnect solution in complementing a healthcare organization's existing patient accounting or practice management system.
Moody’s sees potential positive RCM impact from AI
Ratings agency Moody’s Investors Service has joined other industry players in identifying ways artificial intelligence can create efficiencies in revenue cycle management. The growing use of the technology potentially could bring accounts receivable balances down and minimize write-offs of past-due balances, according to the three authors of a report published in the company’s “Healthcare Quarterly”…
Igniting revenue cycle’s superpower: Patient advocacy
Larami Oliver took over revenue cycle operations for Heart and Vascular Care in Cumming, Georgia, in the heat of the pandemic, and under her leadership, the division was able to persevere. Key to the operation’s success: a shift in focus from post-claim revenue cycle response to pre-service education and support. “We’ve taken a proactive approach…
With a new rule, CMS looks to crack down on states’ Medicaid disenrollment processes
In its latest effort to stem the ongoing wave of Medicaid disenrollments, CMS issued regulations describing its authority to penalize states for disregarding federal guidelines pertaining to the end of continuous-enrollment requirements. Published Dec. 6 in an interim final rule with comment period, the regulations took effect immediately and were based on provisions passed by…
Key Senate committee takes a close look at healthcare waste and prices
The U.S. Senate is intent on finding ways to improve the value of healthcare, according to takeaways from a recent hearing of the Budget Committee. Although other committees and subcommittees in both chambers of Congress have held meaningful hearings about healthcare policy and costs this year, the Budget Committee’s attention to the matter is especially…
10 Keys to Restoring Trust in Healthcare
The issue of restoring consumer trust in the U.S. healthcare system encompasses a wide range of concerns. Factors in the perceived loss of trust include anxiety and confusion over costs, entrenched inequity, a glut of misinformation about vaccines and other treatments, and data and privacy breaches. To examine the problem and explore solutions, HFMA’s 16th…
Prior authorization in Medicare Advantage remains in the policy spotlight as 2024 regulations take effect
Healthcare policymakers and stakeholders continue to mull the need for guardrails to ensure optimal customer service among Medicare Advantage (MA) health plans. The American Hospital Association wrote a Nov. 20 letter to CMS stating that MA plans are looking to skirt policies designed to ensure straightforward coverage of essential healthcare services. These policies, finalized earlier…
Congress doesn’t seem to be mulling a fix for the 2024 Medicare physician payment cut
Congress has mitigated a scheduled Medicare payment cut for physicians going into each of the last three years, but relief does not appear to be on the way for a fourth year running. Medicare’s 2024 final rule for physician payments includes a $1.15 decrease to the conversion factor, amounting to a reduction of more than…
Payer scorecards hold promise for promoting an enhanced payer-provider equilibrium
The U.S. healthcare system is fraught with inherent complexities in how providers receive payment for the services they deliver. And those complexities include conflicting methodologies that too often breed contentiousness between payers and providers around how, when and whether services will be reimbursed. Payer scorecards offer an effective solution for mitigating these tendencies. While they…
Proposed rule sets Medicare penalties for providers that commit information-blocking infractions
Hospitals and other healthcare providers would face penalties for knowingly engaging in information blocking, with the sanctions affecting their Medicare reimbursement, according to a proposed rule from the U.S. Department of Health and Human Services (HHS) and CMS. Published at the beginning of November, the rule implements some terms of the 21st Century Cures Act,…