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.
Research highlights ways to save more than $250 billion per year through healthcare administrative simplification
Savings can be generated at the organizational and healthcare industry levels through steps to reduce wasteful administrative processes, study authors wrote.
Healthcare News of Note: Healthcare insurers owe hospitals billions of dollars in payments and are putting more patients in a bind with retroactive claim denials, says Kaiser Health News
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Insurers are behind in billions of dollars in payments to hospitals, the strain on clinicians and staff grows amid the pandemic, and CFO duties involve more digital activities and investor relations.
The finalized arbitration process in new surprise-billing regulations appears to favor insurers over hospitals
A new rule establishes a process for resolving payment disputes between health plans and hospitals when regulations on surprise billing begin in 2022.
Healthcare News of Note: U.S. will be short 3.2 million lower-wage healthcare workers within 5 years, says Mercer
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Shortages of lower-wage healthcare workers, nurses, physicians and mental health staff are expected, PHI security and burnout are of concern to most healthcare professionals, and the pandemic is expected to affect health insurance rates.
Site-of-care payment issues get highlighted by UnitedHealthcare and MedPAC
A new report issued by a leading health plan is the latest sign that hospitals and health systems can expect payers to ramp up implementation of site-neutral payments.
Recipients of COVID-19 vaccine boosters won’t have to pay anything out of pocket, CMS confirms
Medicare beneficiaries will owe nothing out of pocket for receiving an authorized booster dose, and the same applies to almost all Medicaid beneficiaries and most commercial health plan members.
Healthcare price transparency initiatives may fall flat due to systemic factors, expert says
Niall Brennan, a leading expert on healthcare cost drivers, is among the skeptics who doubt the ongoing price transparency push can result in a more efficient system.
New rule describes the penalty associated with regulations on surprise billing
A new rule from HHS sets forth the maximum penalty for violations of new patient-billing regulations that take effect Jan. 1, 2022.
AMA releases 2022 CPT code set with new options that apply to COVID-19 vaccination, digital care services and more
The new set features more than 400 CPT code changes from 2021.