Revenue Cycle and Payer News – May 24, 2023
Latest news being reported on payers and the health insurance industry including news from CVS Health, IBX, UnitedHealthcare, Humana, CareSource, Cigna, AHIP, Superior HealthPlan and more.
Read MoreHealthcare Revenue Cycle and Finance
Technology and Automation Improving Claim Recovery and Denial Management
By Jane Austen – Healthcare revenue cycles struggle with claim denials. Denial management investigates each denial, determines why it was denied, and determines how to fix the problem and reduce future denials. Sophisticated and robust automation, designed to meet providers’ needs and achieved through AI and ML, empowers organizations to…
Navigating Denials, Optimizing Revenue and Mitigating Staffing Shortages
By Deepali Narula – A three-pronged approach hospitals should follow to navigate denials, optimize revenue and mitigating staffing shortages Three out of four hospitals in the U.S. have experienced revenue cycle issues since the COVID-19 pandemic.
How Artificial Intelligence Solutions are Transforming Medical Insurance Claims Processing
By Dmitrii Evstiukhin – Medical insurance claims processes create mounds of documents that often get backlogged or denied, slowing business operations and reducing efficiency. Now AI solutions are dramatically accelerating medical claims processing while reducing errors and enhancing overall efficiency.
Revenue Cycle and Payer News – April 26, 2023
Latest news being reported on payers and the health insurance industry including news from Oscar Health, AHIP, Independence Blue Cross, Independence Health Group, CVS Health, UnitedHealth Group, Humana, and more.
Hospitals Posted Record Profit Margins?
By David Burda – To answer the question in the headline, which I haven’t seen anywhere yet, is yes. Yes they did. That’s according to the latest annual March report to Congress from the Medicare Payment Advisory Commission, or MedPAC.
Why Providers Need to Meet Patients Where They are for Payment Flexibility
By Rajesh Voddiraju – More than ever, providers need to deliver greater payment flexibility and transparency to patients amidst the proliferation of high-deductible health plans and soaring patient balances.
Avoiding Billing Headaches in a Growing Practice
By John Wallace PT MS – Many growing practices need help scaling their people-driven processes, including billing workflows. No matter what the challenge a solution is streamlining billing operations without relying solely on software.
Sutton’s Law, Humana and Medicare Advantage
By David Burda – I didn’t know this until I looked it up, and that there’s a thing called “Sutton’s Law” that medical schools teach to medical students. The law basically says first order the diagnostic tests that will confirm or rule out the most likely diagnosis of a patient’s illness or injury.