Revenue cycles challenged by mandates of No Surprises Act

Susan MorseDecember 5, 2022

The No Surprises Act has reportedly done its job in preventing an estimated nine million surprise medical bills since going into effect at the start of this year, ...

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HFM: No Surprises Act Regulations Remain Moving Target for Compliance

Nick HutNovember 3, 2022

Amid all the rules stemming from the No Surprises Act, a looming mandate for providers to send cost estimates to health plans looks like the biggest stress inducer.

 

Various regulations under the No Surprises Act have created strain for healthcare finance professionals since the initial rules were published in mid-2021, ...

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RACMonitor: Why Too Much News is a Good Thing

Dr. Ronald HirschOctober 18, 2022

It is time for another multi-topic update. Some weeks produce just too much news to limit my reporting to one topic.

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RACMonitor: AMA Misses Opportunity to Simplify Hospital E&M Coding

Dr. Ronald HirschSeptember 25, 2022

AMA scores a hit with new guidelines; misses simplification of one subset of hospital E&M codes.

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RACMonitor: Medicare Advantage -- No Apparent Advantage for Some

Dr. Ronald HirschSeptember 16, 2022

Complaints are abundant from beneficiaries.

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RACMonitor: Patient Truly Ill? Why Random Audits Could Prevent Recoupment

Dr. Ronald HirschSeptember 9, 2022

Recently, the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) released an interesting audit. They audited billing of critical care visits by physicians who are employed by Lahey Clinic in Massachusetts. As usual, they planned to audit 100 admissions but then, as they describe, because of the ...

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RACMonitor: Shameless -- The Paradox of Healthcare Regulations

Dr. Ronald HirschAugust 18, 2022

Lots to report in this regulatory update.

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RACMonitor: CMS Announces New Appeal Rights – Process To Be Determined

Dr. Ronald HirschAugust 12, 2022

Earlier this year, a federal appeals court issued an opinion on Barrows v. Becerra, a long-running class action lawsuit. Filed by a group of Medicare beneficiaries, the suit alleged they had to pay out of pocket for skilled nursing care—despite being hospitalized for over three days—because their stay was outpatient and did not meet the ...

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RACMonitor: Understanding the Medicare Case-By-Case Exception

Dr. Ronald HirschJuly 28, 2022

Exceptions should be never rare nor unusual.

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RACMonitor: Will Rural Emergency Hospitals Save Rural Health Care?

Dr. Ronald HirschJuly 22, 2022

All eyes are on the new proposal put forth by CMS to create Rural Emergency Hospitals.

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