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.
Ramifications of a proposed rule to halt credit reporting of medical debt
A proposed rule from the Consumer Financial Protection Bureau (CFPB) would curtail the inclusion of medical debt in credit evaluations, potentially shaking up healthcare billing and collections processes. The CFPB framed part of its rationale for the June 11 rule in the context of privacy, noting Congress previously limited the sharing of a patient’s medical…
As providers seek resolution of continuing Change Healthcare issues, UnitedHealth Group reports strong financials
The aftermath of the Change Healthcare cyberattack affected the second-quarter financials of parent company UnitedHealth Group (UHG), but not to the point of hindering the company’s continued “diversified and durable growth,” CEO Andrew Witty said during a recent investor call. Q2 revenues increased by 6% year-over-year, while profits dropped by 5.5% amid costs stemming from…
How healthcare providers can streamline A/R through partnerships
The efficient management of accounts receivable (A/R) is essential for maintaining the fiscal health and operational effectiveness of any healthcare organization. Finance leaders are increasingly recognizing the benefits of leveraging strategic A/R partnerships to improve revenue cycle operations, decrease costs and boost liquidity. It is imperative, however, that they take a systematic approach to understand…