News

Article
Physician Advisory
Prior Authorization

Dr. Ronald HirschJuly 6, 2020

Medicare Prior Authorization Program – 10 Things to Know

Today is the first day that prior authorization is required for Medicare beneficiaries to undergo specific surgeries. Here are the 10 things you need to know about the program.

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Article
Physician Advisory
Prior Authorization

Dr. Ronald HirschJune 18, 2020

Prior Authorization for Medicare Two Weeks Away

We are two weeks away from the start of the Medicare prior authorization program, and as of June 17, the Medicare Administrative Contractors (MACs) were required to start accepting requests.

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Article
COVID-19
Hospital Management
Physician Advisory

Dr. Ronald HirschMay 28, 2020

RACMonitor: ASC Partnership as a Hospital Without Walls

Everyone is anxious for life to return to normal, but none more than those patients who had planned to have surgery in March or April, but had their surgery cancelled due to the COVID-19 pandemic. These patients have conditions that warrant surgery, but were deemed not to be urgent or emergent, and therefore ...

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Article
CMS
COVID-19
Physician Advisory

Dr. Ronald HirschMay 26, 2020

RACMonitor: Confusion Remains over Medicare Guidance on Treating Patient Homes as Hospital Departments

There is continued confusion over the use of patient homes as off-campus, provider-based clinics for Medicare billing purposes. This is the provision in the Centers for Medicare & Medicaid Services’ (CMS’s) second recent Interim Final Rule (IFR) that allows hospitals to bill for services provided by employed ...

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Article
Revenue Cycle
Revenue Integrity

Johnny PezzutoMay 19, 2020

HIT Consultant: Four Must Haves of a Revenue Integrity Solution

For multiple years in a row, chief executive officers (CEOs) participating in the American College of Healthcare Executives’ annual survey ranked financial challenges as the number one issue facing hospitals.[1] With sound revenue cycle management and, in turn, ...

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Article
COVID-19
Physician Advisory

Dr. Ronald HirschApril 19, 2020

RACMonitor: SNF-Eligible Patients with Nowhere to Go

With this pandemic new issues seem to appear daily. The increasing difficulty with skilled nursing facility (SNF) placement led me to write this article and it appears to have struck a chord with many. As with research into medical interventions, the timeline for contemplating, writing, and editing has shrunk ...

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Article
COVID-19
Physician Advisory

Dr. Ronald HirschApril 15, 2020

RACMonitor: The COVID-19 Victims We Aren’t Discussing

The exact number of deaths from COVID-19 is an area of uncertainty. In the midst of a pandemic, data reporting is likely far down on the list of crucial activities. It remains unclear how to count the death of a patient who dies with evidence of infection by coronavirus, but was never diagnosed with COVID-19. ...

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Article
Automation
Prior Authorization
Revenue Cycle

Alia PaavolaApril 10, 2020

Becker's Hospital Review: Why Automation is a Must for Prior Authorization

Despite a push by healthcare organizations in recent years to automate the prior authorization process, it is still primarily manual, prolonging the significant financial and administrative burdens absorbed by providers, patients and health plans. 

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Article
Automation
Revenue Cycle

Joe PolarisApril 10, 2020

RevCycleIntelligence: How AI Is Optimizing Revenue Cycle Management

Prior authorizations are one of the most burdensome aspects of revenue cycle management.

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Article
CMS
COVID-19
Physician Advisory

Dr. Ronald HirschApril 9, 2020

RACMonitor: CMS Clarifies Patient Financial Responsibility for COVID-19 Testing

RACmonitor.com news asked Dr. Ronald Hirsch, vice president at R1 RCM, to summarize the latest from the Centers for Medicare & Medicaid Services (CMS) on covering costs for COVID-19 care. In response, Dr. Hirsch provided RACmonitor the following summary.

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