Payment Reimbursement and Managed Care

Video: Tips for Direct-to-Employer Contracts from UNC Health

Understanding the time commitment and negotiation strategies around direct-to-employer contracts are key areas for payment and reimbursement leaders to consider.

HFMA February 16, 2017

Finding a Better Way to Handle Claim Attachments

Standardizing the electronic submission of claims attachments is a hot topic in the industry as stakeholders look for ways to reduce costs.

Laura Ramos Hegwer February 15, 2017

Ask the Experts: Payer Payments

Are there any benchmarks for how quickly payers should get back to us on claims and denials?

HFMA February 15, 2017

Managing the Ethical Aspects of MACRA

Value is the key driver and organizing principle of MACRA and MIPS. Therefore, it is critical to define value from the view of different healthcare stakeholders.

William Marty Martin February 14, 2017

Identifying the Gap Between Hospital and Free-Standing Prices

One-third of healthcare finance leaders have created separate pricing for certain outpatient procedures versus inpatient procedures to mitigate volume migration from hospitals. Their greatest concerns are how low the pricing should go and how will this pricing impact the bottom line.

Jamie Cleverley February 14, 2017

The Hospital’s Expanding Authority over Authorizations: The Good, the Bad and the Reality

Heather Kawamoto underscores the need for hospitals to improve on the slow manual process of requesting authorizations as they take on this responsibility.

Heather Kawamoto February 8, 2017

The Self-Pay Compliance Problem: Payment Security

David King discusses the hospital’s role as “merchant” when patients use credit cards to pay for their care.

David King February 2, 2017

HFMA Final Rule Summary: Advancing Care Coordination Through Episodic Payment Models

This document consists of three separate summaries of CMS's final rule implementing three new Medicare Parts A and B episode payment models, a Cardiac Rehabilitation (CR) Incentive Payment Model and modifications to the existing Comprehensive Care for Joint (CJR) Replacement Model.

HFMA February 1, 2017

Bundled Payments: Value-Based Guidance

The authors share insights about bundled payment programs in an ever-changing healthcare environment.

Amol Navathe February 1, 2017

Value Based Payment Coalition Letter

HFMA and other healthcare stakeholders, sent a letter to the White House and Congressional leaders in support of the continued movement toward value-based payment.

HFMA February 1, 2017
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