Congress only has a few more months to ensure expansive telehealth access continues (updated)
Note: This article was updated Sept. 18 and Sept. 19 with information about new telehealth legislation. See the updates below. The clock is ticking on efforts to maintain the telehealth flexibilities that have been in place since the start of the COVID-19 pandemic, with advocates hoping Congress will act before year’s end. Key waivers will…
How to Maximize your Medigap Market Share
A refreshed look at Medigap revenue, the opportunity that exists to increase market share, and the financial impact it has on healthcare organizations. This white paper presents three important considerations for healthcare finance leaders as they look to expand revenue streams and access a growing population of insured Medigap patients.
Harnessing automation in patient access for revenue optimization
Patient access is often treated like a stand-alone process instead of a vital part of the revenue cycle puzzle. The truth is that errors during this critical stage of the revenue cycle are often the cause of claim errors, delayed care and denials. In addition, as the first step of a patient encounter, the patient…
A key election question: What will happen to the enhanced Affordable Care Act subsidies?
Earl Pomeroy knows from experience that the politics surrounding the Affordable Care Act (ACA) are dicey. As a Democratic member of the House Ways and Means Committee, Pomeroy helped pass the ACA during his ninth term representing North Dakota. After that, “I lost my job,” he recalled. Since his time in Congress ended with his…
Healthcare Revenue Cycle Management (RCM) – What It Is & How It Works
Revenue cycle management in healthcare is the process of tracking revenue from patients, including patient registration, claim submission, reimbursement, and communication with insurance companies, and is essential for providing a positive patient experience.
FAQs about Patient Financial Communications
When is it OK to have financial discussions with patients? A reasonable attempt should be made to have the discussion as early as possible, before a financial obligation is incurred (i.e., before care is provided). Timely discussions
Revenue cycle analytics and how providers can help create best practices for the industry
Erin Weber of CAQH discusses how providers can participate in the work of setting best practice guidelines, and Lori Zindl of OS Inc. and Rachel Dallman of Phelps Memorial Health Center talk about opportunities to learn from analytics.
Report: Payer requests for information are slowing reimbursement
Payers are increasingly rejecting claims through requests for information (RFI) that in total serve no purpose other than to delay reimbursement, according to “Death by a thousand requests,” a report from consulting firm Kodiak Solutions. RFI claim denial rates as a percentage of total billed charges climbed to 3.82% in 2024 through May, up from…
Navigating the rising tide of denials
Managing the healthcare revenue cycle is more challenging — and more critical — than ever. Amid sluggish margins, ongoing staffing challenges and rising costs, providers feel unprecedented pressure to optimize their revenue cycles. Addressing the ever-increasing issue of denials is a great place to begin. The latest data on denials and proven strategies to reduce…
Premier’s AI platform offers a data-driven solution for medical group leaders
Learn about how Provider Practice Benchmarking allows medical group leaders to directly measure their performance across more than 150 physician and advanced practitioner specialties in a number of areas from a single reporting platform.