Insurers promise to make prior authorization processes easier for all parties
In potentially a rare dose of good news for providers about prior authorization, the health insurance industry has volunteered to scale back the process and introduce new accommodations, according to an announcement Monday. As described by the insurance lobby and the Trump administration, which convened a meeting Monday at which a large segment of the…
David Johnson: Lessons in solving the nation’s current revenue cycle dilemma
In April 1999, “The Modern Library” published its list of the top one hundred nonfiction books of the 20th century. Number one was “The Education of Henry Adams,” an intellectual autobiography written in 1905 by the great grandson and grandson of John Adams and John Quincy Adams, respectively, the second and sixth presidents of the…
How to empower revenue cycle employees to solve problems: a case study of Mass General Brigham
In traditional revenue cycle structures, managers move up the hierarchy because they are good at getting work done and solving problems. However, a successful continuous improvement culture needs not only effective managers but also empowered front-line staff who can share their insights and expertise. With this premise in mind, leaders at Mass General Brigham (MGB)…
Insurers, patients pay less of their bills
Healthcare providers faced growing challenges last year in getting paid for care among patients covered by insurance, according to new benchmark data from Kodiak Solutions. And it was both insurers and patients who were lagging in payment or not paying at all. Denials of coverage by health plans, already a problem in 2023, increased during…
5 key strategies for a successful mid-cycle
Today’s mid-cycle teams face mounting pressure. Oversight is tightening, payer policies are shifting rapidly and margins continue to shrink. This phase is no longer a simple pass-through, it’s a vital operational checkpoint that demands both strategic leadership and attention to detail. Hospitals that implement structure and prioritize accuracy tend to stay ahead. Those that don’t…
Vendor and staffing management, plus the latest in budget reconciliation
Danelle Newman from OSS Health discusses how to strike a balance in vendor and staffing management. Also in this episode, HFMA Senior Editor Rich Daly talks with HFMA Policy Director Shawn Stack about the House-passed reconciliation package.
How Revco Solutions maximizes cash recoveries and improves the patient financial experience
Learn how one company optimizes revenue recovery through proactive denial prevention, clean claims strategies and intelligent automation — ensuring faster, more accurate reimbursement.
How to strengthen eligibility determination with a proactive approach
How can healthcare revenue cycle teams strengthen engagement around eligibility determination and improve patient satisfaction, operational efficiency and their bottom line? Discover solutions to these challenges in this white paper.
Fortifying revenue management: The critical role of health information management in cybersecurity preparedness
A hospital’s health information management (HIM) team oversees the flow of patient care documentation in healthcare organizations, supporting accuracy, accessibility and security. In the revenue cycle, HIM maintains financial integrity by managing patient data, ensuring proper coding and documentation for billing and verifying clinical data for compliance and reimbursement. HIM also plays an active role…
CFPB no longer supports the final rule on medical debt reporting
The Consumer Financial Protection Bureau (CFPB) has formally withdrawn its support for a Biden administration rule that would keep medical debt from appearing on consumer credit reports. The rule has been staunchly opposed by the credit-reporting and debt collector industries and also has generated concern among provider advocates who think it could remove an incentive…