Revenue Cycle & Payments Archive
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.
Though analytics can be descriptive and predictive, today most healthcare organizations are users of descriptive analytics, leveraging reporting tools and applications to understand what has already happened in the past to classify and categorize historical data.
Concerns that nationwide electronic health record adoption could lead to widespread fraudulent coding and billing practices that result in higher healthcare spending are unfounded, according to a study from the University of Michigan School of Information and the Harvard School of Public Health.
Analysis of data on ambulatory providers satisfaction with their claims clearinghouses finds many are generally pleased with their vendors performance.
Among the multitude of tasks to prepare for the ICD-10 code sets, providers also should conduct two core tests with insurers: Acknowledgement testing, also known as historical validation testing, and End-to-End testing.
FAIR Health, which operates a database of 17 billion medical and dental claims, has unveiled the top 15 medical and dental services for which consumers have searched for cost information.
The Centers for Medicare and Medicaid Services has certified the Health Care Cost Institute as the first national "Qualified Entity" to have full access to national Medicare claims data for reporting on the costs and quality of healthcare services.
Under a proposed rule setting the Part B physician fee schedule for calendar year 2015, Medicare would expand payment for certain medical and mental health services furnished via telemedicine technologies.
Medicares Fraud Prevention System that uses predictive algorithms to analyze provider billing patterns caught nearly $211 million in improper Medicare payments during the past year.
Nearly all inconsistencies for those who enrolled for healthcare through the Affordable Care Acts federal exchanges were unable to be resolved due to Centers for Medicare and Medicaid Services systems not being fully operational.