Health Plan Payment and Reimbursement

Ask the Experts: Out-of-Network Payments

What are some successful strategies for increasing the amount of charges paid by out-of-network insurance carriers?

HFMA October 11, 2016

Ask the Expert: Payers Linking Cancellations of Separate Contracts

How can providers respond when payers threaten to terminate a Medicare Advantage contract if the provider terminates their separate commercial contract?

HFMA April 7, 2016

Ask the Experts: Non-Contracted Insurer Payment Rates

How can providers respond when non-contracted insurers offer payments limited to some share of Medicare payments for a given service?

HFMA January 12, 2016

HFMA Comments on Interim Final Rule on Third Party Payment of Qualified Health Plan Premiums

HFMA comments on CMS's IFR to codify the guidance related to third party premium payment for individuals enrolling in QHPs. However, the IFR does not resolve the ambiguity created by CMS’s conflicting statements on the issue.

HFMA May 12, 2014

Fact Sheet: Standards for Consumer Assistance Programs for Healthcare Insurance Exchanges

This fact sheet provides details of CMS's rule outlining training requirements applicable to assistance personnel in healthcare insurance exchanges mandated under the Affordable Care Act.

HFMA August 9, 2013

Managed Care Ask the Expert Answer – Robotic Surgery

 Q Are commercial payers paying for additional charges billed by hospitals for robotic surgery? At least one payer that pays on a % of charges basis is not paying the charges for the robotic surgery, additional OR time, etc. and

HFMA October 25, 2012

Payment & Reimbursement Forum Articles

An archive of Payment & Reimbursement Forum's articles, featuring our latest content and past articles categorized by topic.

HFMA October 17, 2012
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );