In the United States, prior authorization (“PA”) is a cost-containment tool utilized by payers to reduce payment for medically unnecessary or inappropriate patient care. Despite its laudable policy goals, the use of PA faces
Dear Health Leaders,
In the world of revenue cycle ...
If you’re like most healthcare executives, you've probably spent countless hours thinking about a host of challenges including razor thin margins, the labor market, and how to improve the patient experience. You’ve probably read articles about RCM outsourcing, watched webinars and analyzed data about the impact it can have. Maybe you’ve even ...
The proposal from the Centers for Medicare & Medicaid Services to codify the requirement that all Medicare Advantage plans use the Two-Midnight Rule for determining admission status of all patients has some talking that the use of commercial criteria will become obsolete. ...
RCM outsourcing and technology go hand-in-hand. The robust technology offered by outsourcing partnerships can offer streamlined workflows, intelligent automation, and unparalleled accuracy, all of which can lead to reduced costs and increased revenue collections. These benefits are a big reason why
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The No Surprises Act of the 2021 Consolidated Appropriations Act (“NSA”) established requirements for healthcare providers to deliver Good Faith Estimates (“GFEs”) for scheduled services or upon patient request.
Key Takeaways:
Federal price transparency requirements for hospitals from the Centers for Medicare & Medicaid Services (CMS) provide patients with an unprecedented amount of insight into the costs for medical services.1
In theory, more pricing information should ...
While the healthcare industry continues to climb its way out of a pandemic, it’s also facing unprecedented challenges, including severe labor shortages and shrinking margins. What if there was a global delivery model that could help the industry during this challenging time?
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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