Billing and Collections

Looking to break through the cultural silos that can hamper operations at hospitals and health systems, Monument Health has engineered a new brand of clinical-finance collaboration. Headquartered in Rapid City, South Dakota, the community-based health system established a dyad leadership structure in which a clinical leader has joint oversight of the revenue cycle. It’s a…

A physician association continues to roil the No Surprises Act’s arbitration process through successful litigation. For the second time in a year, the Texas Medical Association (TMA) prevailed in court after arguing that regulations governing the independent dispute resolution (IDR) process do not comply with legislative intent. Barring a successful appeal, the Feb. 6 ruling…

In this HFMA executive roundtable, seven health system leaders share their efforts to effectively engage patients and the lessons they have learned along the way.

Debt collections are often the last communication touch point a patient has, and health systems should ensure their business partner is representing the organization in the best possible manner. See how one company eases the collections process for staff and consumers.

The No Surprises Act’s independent dispute resolution (IDR) process has become more expensive for healthcare stakeholders. For the new year, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration increased from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and…

How can health systems and patients both win when it comes to payment? Read this article to learn how hospitals can maximize collections and get paid for provided services on top of how patients can identify source of payment that is not out of pocket.

Health systems seeking to improve their accounts receivable function are turning to machine learning and AI to streamline patient interactions in ways that benefit the organizations and their patients. Read the challenges and benefits of using automation health system executives discuss in this roundtable.

Medicare administrative contractors (MACs) soon could apply more scrutiny to providers’ reported bad debts if CMS implements recommendations from the HHS Office of Inspector General (OIG). OIG in December issued a report in which it examined bad-debt reimbursement claims on Medicare cost reports spanning 2016 through 2018 for 67 randomly selected providers (including 29 hospitals). In those…

The No Surprises Act’s independent dispute resolution (IDR) process is about to become more expensive for healthcare stakeholders. In 2023, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration will increase from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and Insurance…

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Trust increased in healthcare providers’ handling of the pandemic when compared with the government, working-age adults suffer financial setbacks after admission for traumatic injury, and deaths by stimulants have increased.