Revenue Cycle & Payments Archive
The Centers for Medicare and Medicaid Services does not have reliable data nor provides sufficient oversight to measure and prevent payment contractors--particularly Recovery Audit Contractors--from conducting certain duplicative post-payment claims reviews.
Medicaid enrollees visit the emergency department appropriately like most patients, but they have generally more complex health needs and less access to primary care than their privately insured counterparts.
Jersey City Medical Center is offering an undisclosed number of patients a year of identity protection services after an unencrypted CD shipped to a New Jersey Medicaid payment review contractor never arrived at its destination.
The New York City Department of Health and Mental Hygiene (DOHMH) has selected the InsightCS revenue cycle management system developed by St. Louis-based Stockell Healthcare.
Engagement platform vendor Change Healthcare's latest quarterly Healthcare Transparency Index (HCTI) reveals that the widest variation in costs for selected inpatient procedures and imaging services is found among the facilities where the procedure or service is performed--not among the professionals who performed them.
Reps. Diane Black (R-Tenn.) and Earl Blumenauer (D-Ore.) have introduced the Value-Based Insurance Design (VBID) for Better Care Act of 2014, a measure that would establish a regional demonstration program for high-quality Medicare Advantage plans to utilize V-BID to reduce the co-payments or coinsurance for beneficiaries with specific chronic conditions.
In a final rule setting 2015 payment rates for skilled nursing facilities, the federal government reiterates a commitment to accelerate SNF use of health information exchange technology.
The Centers for Medicare and Medicaid Services is restarting the controversial Recovery Audit Contractor Programin a limited fashionin August.
Small physician practices using telemedicine can make quality care more accessible to patients in underserved communities, but numerous barriers are preventing the technology from realizing its potential, according to a July 31 congressional hearing.
With 27 days remaining for physicians to contest the accuracy of reports on payments and items of value received from drug, biological and medical device manufacturers, the American Medical Association reminds members of helpful resources on its website.
A data analysis reveals that expenses for deductibles and other out-of-pocket costs are changing inconsistently among the four categories of Accountable Care Act plans.
The Electronic Healthcare Network Accreditation Commission, which certifies entities that process transactions or exchange health information for meeting best practices, is launching new programs to accredit accountable care organizations and physician practice management systems.
Digital health funding reached $2.3 billion in the first half of 2014--an unprecedented level of venture capital exceeding the 2013 total--according to Rock Health, which funds and supports early stage healthcare companies.
The Robert Wood Johnson Foundation and athenahealth have released the first in an ongoing series of comprehensive reports based on the organizations' ACAView, a joint initiative that measures the impact of the Affordable Care Act on providers, patients, and physicians.
When Aetna starts work with delivery systems to form accountable care organizations, the insurer typically analyzes claims data to get a picture of a providers present status and guide creation of an efficiency model.