Denials Management

HFMA’s new Premium Facilitated Learning courses combine self-directed study with facilitator feedback and time for peer problem solving

Learn more about HFMA’s Premium Facilitated Learning — a new line of courses — that combine self-directed study with expert facilitation in this Q&A with HFMA’s Sue Spear, director of Digital Learning and Todd Nelson, director of Partner Relationships.

Stephani Johnston January 11, 2022

How to unleash the true value of your remote reps using workforce management

A data-driven management approach to revenue cycle that empowers your staff could effect sweeping change for improved long-term financial health.

HFMA November 4, 2021

Hospitals and Congress propose improvements to prior authorization processes in Medicare Advantage

The American Hospital Association says pending regulations that would affect prior authorization should be expanded to include Medicare Advantage.

Nick Hut October 22, 2021

Healthcare News of Note: National index shows denials are up 11% since the onset of COVID-19

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Denials are up since the onset of COVID-19, nonprofit hospitals’ community investing falls short, and pediatric clinicians use the EHR less than other clinicians.

Deborah Filipek July 21, 2021

UnitedHealthcare reverses course on new approach to emergency department claims, but perhaps only temporarily

UHC had announced this week that it would evaluate claims starting July 1 to determine whether ED visits were for emergent or nonemergent events.

Nick Hut June 10, 2021

Looming UnitedHealthcare policy on coverage of emergency department care draws opposition from hospitals, physicians

In a move strongly opposed by provider associations, UnitedHealthcare soon will start denying coverage of ED care that it deems to have been nonemergent.

Nick Hut June 10, 2021

2 proven strategies that can help healthcare providers reduce denials and strengthen their revenue cycle

Healthcare providers should consider the use of two proven strategies to reduce claim denials: Maximize reps follow up ability and close the gap between the front end and back end with a continuous feedback loop.

HFMA June 7, 2021

Inside HFMA: It’s time for healthcare providers to standardize denials performance measurement

HFMA’s Claim Integrity Task Force, in collaboration with business partners, set out to scope and define metrics that could be adopted industrywide for benchmarking.

Chuck Alsdurf May 26, 2021

New HRSA funding is available to providers that administer the COVID-19 vaccine and don’t receive full payment from a health plan

The Health Resources and Services Administration announced a new program to reimburse healthcare providers for administering COVID-19 vaccines to patients whose health plans either do not cover vaccination fees or require cost-sharing.

Nick Hut May 4, 2021

Denials management: An underrated tool for optimizing value-based revenue

Effective denials management not only supports a strong revenue stream under existing fee-for-service payment models, but also is a key tool for managing the full range of value-based payment contracts.

Daniel J. Marino March 1, 2021
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