Revenue Cycle

Seeking to phase out Medicare DSH payments, MedPAC outlines potential changes to reimbursement for safety net providers

Revamped formulas for hospitals and physicians would be designed to better target payments to providers that treat larger shares of low-income Medicare beneficiaries.

Nick Hut January 18, 2023

Beyond automation: Fulfilling your New Year’s resolution for a more efficient revenue cycle

Jonathan Wiik, vice president of health insights at FinThrive, discusses how provider organizations continue to struggle with denials in a time when staff is hard to find.

Erika Grotto January 17, 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

4 tips for simplifying prior authorizations

Healthcare spending in the U.S. has reached what many consider to be unsustainable levels. While spending in other developed nations averaged 8.8% of GDP in 2019, it was nearly double that in the U.S. at 16.8%. One of the major contributors to this spending is administrative waste, which accounts for up to 30% of our…

HFMA January 6, 2023

Medicare contractors should more closely examine providers’ bad debt claims, HHS watchdog says

Medicare administrative contractors (MACs) soon could apply more scrutiny to providers’ reported bad debts if CMS implements recommendations from the HHS Office of Inspector General (OIG). OIG in December issued a report in which it examined bad-debt reimbursement claims on Medicare cost reports spanning 2016 through 2018 for 67 randomly selected providers (including 29 hospitals). In those…

Nick Hut January 3, 2023

For the No Surprises Act arbitration process, 2023 brings a steep fee hike and continuing litigation

The No Surprises Act’s independent dispute resolution (IDR) process is about to become more expensive for healthcare stakeholders. In 2023, the nonrefundable administrative fee due from each party involved in any payment dispute that goes to arbitration will increase from $50 to $350, according to a Dec. 23 memo from CMS’s Center for Consumer Information and Insurance…

Nick Hut December 30, 2022

International member spotlight: Aleetta Baby uses certification to enrich her career and look to the future

Aleetta Baby’s enthusiasm for her work is evident in her dedication to learning new skills. “I enjoy working in revenue cycle management because each day presents a new learning opportunity, task or challenge.” Baby, revenue cycle managementfinancialanalyst at Sheikh Shakhbout Medical City (SSMC) in Abu Dhabi, has completed her Certified Revenue Cycle Representative (CRCR) certification and says…

HFMA December 15, 2022

Vanderbilt Health harnesses data to improve revenue cycle management

Close to half of healthcare finance professionals say in a survey that their organizations are experiencing a severe shortage of revenue cycle management (RCM) talent — and many are exploring automation as a way to keep RCM operations working properly. It’s a move that Vanderbilt Health in Nashville, Tennessee, made just prior to the pandemic — and…

Jeni Williams December 13, 2022

New federal rule aims to eventually ease prior authorization processes

CMS is seeking to improve the prior authorization process in government programs such as Medicare Advantage (MA) and Medicaid, although the core provisions would not begin until 2026. The agency this week updated a Trump administration proposed rule with new proposals to “improve patient and provider access to health information and streamline processes related to prior authorization…

Nick Hut December 9, 2022

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
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