What We’re Reading – June 2024

June 4, 2024

Here’s a sampling of the recent articles R1 revenue cycle experts are reading (and writing):

HIT Consultant
How AI Can Increase the Success of Clinical Denials Appeals

A perfect storm of financial pressures is stunting revenue growth for healthcare providers. Rising costs and labor shortages constrain capacity and ever-increasing denials, delays and underpayments choke off cash. But providers have the option to apply modern technology – including analytics, automation, and AI – to help improve their claims management processes to not only prevent denials upfront but also identify improvements to continuously hone processes, and efficiently resolve denials that can be overturned.

Becker’s Hospital CFO Report
Health Systems’ Hard Line on Insurers Pays Off

Health systems are taking a tougher stance with commercial payers, arguing that they are not being adequately reimbursed for services provided to patients, and some providers have gone out of network if contract renewal offers have not been up to par. Medicare Advantage plans are a point of particular pain for many health systems.

Becker’s Health IT
What Healthcare Learned from the Change Hack

The February cyberattack on Change Healthcare affected provider organizations across the country as revenue flow was crippled. But what has healthcare learned, if anything, from the incident? Healthcare revenue leaders say diversifying your clearinghouse relationships and carefully vetting vendors are good ways to minimize damage to your bottom line from a cyberattack on a key vendor.

HFMA
340B Providers Are at a Disadvantage After the Latest Court Ruling on Contract Pharmacies

A decision issued by an appeals court represents the latest setback for 340B providers hoping to secure widespread access to price discounts on Medicare Part B drugs. The court of appeals for the District of Columbia circuit has decided that the 340B statute does not prohibit drug makers from putting conditions on the distribution of its drugs through contract pharmacies.

 

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