Denials Management

News Briefs: 2023 brings a steep fee hike for No Surprises Act arbitration cases

The No Surprises Act’s independent dispute resolution (IDR) process has become more expensive for healthcare stakeholders. For the new year, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration increased from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and…

Nick Hut January 27, 2023

Key points to know in recently proposed rules for Medicare Advantage and the ACA marketplaces

A proposed rule for health plans in Medicare Advantage has provisions designed to stem overreach in prior authorization processes.

Nick Hut January 20, 2023

Labor costs and other concerns dampen the outlook for not-for-profit hospitals this year

Insights from a leading credit-rating agency illustrate the scope of the financial challenges facing not-for-profit hospitals in 2023.

Nick Hut January 10, 2023

How healthcare organizations can defend against financial hazards in 2023

What are the most critical strategies to steer healthcare organizations in the direction of financial stability in the following year and beyond? A couple tips include reducing bad debt and accessing external benchmarks for supply pricing.

HFMA December 6, 2022

Utilization Review: 5 Reasons Hospitals Lose Revenue

An effective utilization review program must revolve around the right management and processes as well as communication among teams.

Lisa Bragg and Amanda (Fishman) Koroly December 5, 2022

Delivering scalable, patient-focused revenue cycle management services

A revenue cycle management company talks about the importance of experience, versatility, and customer service when responding to current and emerging revenue cycle challenges.

HFMA August 31, 2022

Improve cash flow and cost of reworking denials with the efficientC claim scrubber technology

In five years’ time, denial claims have shot up 20%. Learn about a decision support and claims management technology platform that stops claims before they get denied.

HFMA August 31, 2022

PMMC’s Contract PRO helps hospitals see an average 10 to 1 ROI

When the time comes to renegotiate payer contracts, one company’s contract management system “provides managed care leaders with the ability to model all commercial payer contract terms to quickly understand the impact on net revenue.”

HFMA August 31, 2022

HFMA’s virtual revenue cycle and price transparency series focuses on helping health systems re-engage consumers and improve financial performance

Beginning March 1, healthcare finance professionals can participate in several educational sessions and peer-to-peer discussions by enrolling in HFMA's virtual revenue cycle and price transparency workshop.

Deborah Filipek August 26, 2022

Healthcare News of Note: Only 66 hospitals earn top marks for social responsibility

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Fewer than 2% of reviewed U.S. hospitals earned Lown’s ‘most socially responsible’ distinction, gun violence is a major health problem in the United States, and ACA health insurers denied 18% of all in-network claims in 2020.

Deborah Filipek July 14, 2022
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