2022 healthcare trends driving change in patient financial engagement
Disruptive changes brought on by rising medical costs and increased patient cost sharing require an evolution in traditional patient billing and collection practices. Rapidly changing state and federal regulations, COVID-19, consumer behaviors and expectations, disrupters, technology and operational challenges impact healthcare in parallel.
Leveraging artificial intelligence to advance organizational strategy
When bringing artificial intelligence into their business models, health systems have the opportunity to improve revenue cycle management by maximizing efficiencies. With the potential to improve workflow and consolidate resources, automation and machine learning require organizations to examine their infrastructure, from staffing to datasets. Investing in automated processes to reduce variation and empower staff to…
Digestive diseases led increase in treatment costs over the last two decades, analysis finds
A new study quantifies the extent to which treating disease has become increasingly expensive since just before the turn of the century.
No Surprises Act
As a result of the 2021 Consolidated Appropriations Act, several No Surprise Billing Act regulations will go into effect on Jan. 1, 2022 for providers, facilities and air ambulance services. These requirements include prohibitions on balance billing for certain items and services, consumer notification and consent requirements for insured patients, cost sharing rules and disclosures, and uninsured/self-pay good faith estimate requirements for scheduled or shoppable items and services.
Hospitalists are more likely than other physicians to choose high-intensity codes for inpatient care, study finds
The billing and coding practices of hospitalists may contribute to the rising cost of hospital care in the U.S., according to conclusions of a new study.
Some Medicare payments to hospitals for bariatric surgery may be inappropriate, OIG finds
Medicare could have saved nearly $48 million in bariatric surgery payments to hospitals during an 18-month period if coverage rules and guidance were better implemented at the contractor level, according to the HHS Office of Inspector General.
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.
Big delays could be in store for early No Surprises Act arbitration cases
The portal for payment arbitration cases taking place under the No Surprises Act is open for business but could be facing a backlog of cases.
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.
A best-practice approach to coding, coding quality and compliance improves reimbursement
Healthcare providers need to ensure they are accurately paid for the care provided, and that starts with timely, correct and consistent coding. This critical revenue cycle process codifies the clinical care performed and documented.