Why Health Plans Are Easing Preauthorization
In an attempt to build cooperative working relationships with physicians, some health plans are trying to reduce the burden of preauthorization.
The Future of Value
The move toward value remains a constant although the future of health care is uncertain.
Maximizing Out-of-Network Payment for Patients with ACA Exchange Products
Hospitals should take steps to ensure the receive the full payment to which they are entitled for out-of-network patients enrolled in health plans purchased on the Affordable Care Act insurance exchange.
Ask the Experts: Payer Payments
Are there any benchmarks for how quickly payers should get back to us on claims and denials?
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.
Ask the Experts: Payment Adjustments and Meaningful Use
Our organization has not made any effort to attest to meaningful use, and we have received a notice from CMS with attestation deadline dates in February 2017. Will we experience payment adjustments in the upcoming fiscal year? How can I confirm our status?
Making ACO Participation Pay Off
Delaware Valley ACO’s emphasis on improving care while lowering costs has proven effective, demonstrated by an increase in members from 5,000 to 200,000 in three years.
Ask the Experts Answer: Urgent Care Center
Q: We are opening an urgent care center that will be hospital-based. The consulting team that is setting-up the billing suggests that we have two different charge slips and two different prices -- one for self pay and one for insurance patients. I am not comfortable with this recommendation and would like guidance on charging two different prices.
Ask the Experts Answer: Provider Refunds for Insured Patients
Q: Do you know of any policy/legislation or general practices regarding a provider refunding a payer if the patient was authorized but then later found by the payer to be uncovered because they are secondary?
Ask the Experts – Medicare Payment
Dale BakerDale E. Baker is the President of Baker Healthcare Consulting, Inc. (BHC), an Indianapolis based consulting firm serving over 1,000 acute care hospital clients in forty four states since 1990. BHC specializes in advising clients on Medicare geographic reclassification