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.
4 proven strategies for optimizing revenue cycle performance
Hospitals revenue cycles can all too often experience denied claims and delayed payment due to outdated manual processes and workflow inefficiencies. Hospital revenue cycle leaders can address these problems with a sharper strategic focus on submitting clean claims, managing denials, applying analytics and outsourcing.
Revenue Cycle Insights: May 2022
No Surprises Act implementation continues. Though arbitration cases are expected to be addressed in a slow fashion at first, there may be some related regulatory changes that favor providers, Nick Hut reports.
Strategic alternative dispute resolution offers providers key to substantial claim recoveries
To be able to effectively handle disputes over healthcare claims, providers must be well-informed about the two basic types of alternative dispute resolution that can help them achieve favorable results: arbitration and mediation.
OIG calls out issues with denials of payment and services in Medicare Advantage
Medicare Advantage processes related to prior authorization hamper beneficiaries’ access to medically necessary care, according to a new report from the HHS Office of Inspector General.
HHS policy update: Recent developments include an extension of the public health emergency and notable progress in reducing the Medicare appeals backlog
HHS Secretary Xavier Becerra signed a 90-day extension of the COVID-19 public health emergency, ensuring the PHE will last until at least mid-July.
How LifePoint Health revamped its revenue cycle
Executives for the non-urban focused health system wanted to get all of its hospitals using a single revenue cycle management approach.
Simplifying the revenue cycle while building resilience
“Several senior financial leaders discuss their organizations’ revenue cycle management (RCM) optimization initiatives, focusing on a variety of strategies, including eligibility checks, denials prevention programs and automation.”
Revenue Cycle Insights: February 2022
This month's issue leads off with the news that the federal government is taking a look at provider billing in the COVID era through audits by the Office of Inspector General.
Coverage denials based on medical necessity are far more likely to arise from Medicare FFS rules than from MA plan policies
Coverage rules stemming from Medicare national and local determinations were the most likely cause of claim denials in one Medicare Advantage plan.