Medicare coverage and coding updates: New Alzheimer’s drugs to be covered, but not universally
Note: This article was updated July 6. For drugs manufactured to slow the progression of Alzheimer’s disease, Medicare will offer coverage with certain qualifications, according to a recent CMS announcement. The new policy especially is relevant because the FDA’s first full approval of an Alzheimer’s disease drug may be only a month or so away.…
How Augusta University Medical Center Transformed Patient Access, Improved Patient Experience and Increased Cash Collections to $9M
Augusta University Medical Center (AUMC) was leaving millions on the table and writing off bad debt by not prioritizing pre-service and point-of-service payment discussions. Download the case study to learn how adopting technology to produce accurate cost estimates, and establishing new trainings, protocols and accountability measures around payment collections, helped AUMC transform patient access, enhance…
Out of the back office, into the spotlight: 5 skills revenue cycle leaders need
Healthcare has changed tremendously over the past decade. From increasingly complex payer requirements to growing federal and state regulations to a substantial change in the payer mix (patients are now the second largest payer (27%) behind the federal government (34%), which is mostly Medicare and Medicaid). Today’s revenue cycle is an entirely new animal. What…
Healthcare News of Note: The top 5 reasons U.S. adults say the nation’s healthcare system fails to meet their needs
Nearly three-quarters of adults say the U.S. healthcare system is not meeting their needs in some way, with the length of time to get an appointment the No. 1 reason. The top benefit of using remote patient monitoring during cancer care is to keep the care team up to date on symptoms in between appointments,…
Report quantifies the financial impact of certain health plan business practices on providers
As hospitals seek to regain their financial footing coming out of the pandemic, they may find themselves stymied by commercial payer policies, according to a new report. “It’s true that commercial payers might generate more net revenue than public payers on a per-case basis,” Crowe states in a report it recently published. “But at what…
How healthcare organizations navigate claims processing
View the results of a survey about claims processing and revenue cycle performance conducted with more than 625 healthcare leaders.
Leveraging extensible technology to create consumer-centric healthcare ecosystems
Implementing new technologies can eliminate tedious tasks and open the door for more impactful work as well as provide patients with easier access to convenient scheduling, registration and billing options. Dive into this roundtable for additional insight on technologies progressing the industry.
Healthcare providers seeing more diagnosis-related group downgrades and ghost denials
Each year, tens of millions of medical claims will be denied by healthcare payers. One executive director led a session with more than a dozen attendees highlighting their experiences with DRG downgrades and lessons learned to help other organizations better measure, manage and successfully appeal these complex denials.
The state of Medicare Advantage: As the program grows, healthcare stakeholders express concerns
As seen during a recent virtual conference, the accelerating expansion of Medicare Advantage (MA) has been accompanied by tension over growing pains such as regulatory issues. “I think MA was set up really well, but like anything else there’s sort of a moment where you have to look at the program and say: How do…
Healthcare News of Note: 3 factors increase the likelihood that a physician has been sued
Some46.8% of physicians over the age of 54 report they have been sued compared to 9.5% of physicians under the age of 40. The revenue cycle management segment accounted for the largest revenue share in the global healthcare finance solutions market in 2022. Greater representation of Black primary care physicians (PCPs) in the PCP workforce…