Revenue Cycle and Payer News – March 26, 2025
Reported payers and health insurance industry news from Cigna, Humana, CVS Health, Anthem Blue Cross and Blue Shield, CareFirst BlueCross BlueShield, AHIP, KFF and more.
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Navigating Complex Payer Processes in Behavioral Health
By Ram Krishnan – Navigating payer stipulations in behavioral healthcare can be a challenge, as they are often more complicated than those for physical healthcare. However, understanding how to maintain compliance and bill properly is something that behavioral health clinicians and practice owners have to do to maintain business efficiency, avoid revenue losses, and provide timely care to patients.
Revenue Cycle and Payer News – February 26, 2025
Reported payers and health insurance industry news from The Cigna Group, Blue Cross and Blue Shield, Humana, Cigna, Anthem Blue Cross and Blue Shield, AHIP, Independence Blue Cross, CVS Health, Aflac, and more.
Sounding the Alarm on the Human Cost of Medical Debt
By Meredith Kirchner – Nearly 136 million Americans visit the ER each year for various reasons like chest pain, fever, and shortness of breath. Unfortunately, these high-cost care episodes, whether in ERs, trauma centers, or specialty facilities, carry significant financial burdens for both patients and healthcare systems.
Revenue Cycle and Payer News – January 29, 2025
Reported payers and health insurance industry news from Humana, Aetna, Anthem Blue Cross and Blue Shield, UnitedHealth Group, Banner|Aetna, CVS Health, Cigna, and more.
How a Duty To Spend Wisely on Worker Benefits Could Loosen PBMs’ Grip on Drug Prices
By Arthur Allen – In recent years, the opaque business practices of PBMs have drawn fire. The Federal Trade Commission is conducting a lengthy investigation of the three biggest companies and sued them in September, accusing the firms of driving up insulin prices.
Ensuring Your Service Line Profitability Report Gets the Attention it Deserves
By Christie Scanlon – A carefully crafted Service Line Profitability report can be like a New Year’s resolution: Packed with potential, ready to reveal operational efficiencies, uncover opportunities, and provide strategic recommendations. But if not presented the right way, there is a real risk the most insightful of reports and dashboards will be ignored.
Overcoming Healthcare’s Skills Gap in Revenue Cycle Management
By Chris Klitgaard – Roughly 4.1M Americans will turn 65 every year through 2027. The largest number reaching retirement ever, and Boomers are leading the way. The “silver tsunami” arrives along side of the healthcare industry losing 2M workers by 2029.
The Cost of Healthcare
By Jay Eisenstock – The shocking execution of the CEO of America’s largest health insurer has reignited widespread criticism of the health insurance industry, often viewed as primarily responsible for the high cost of healthcare. While these companies bear some responsibility, the issue is far more complex with blame shared across the entire system.