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Reimbursement

July 7, 2022
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AMA seeks to expand telehealth, reform payment system and prior authorization

During his presidential address at the AMA House of Delegates meeting, Gerald E. Harmon, MD, outlined five actions that he said policymakers must take to better support physicians.

May 6, 2022
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News Briefs: Biden administration will apply closer scrutiny to healthcare billing practices

The White House in April announced steps to try to lessen the burden of medical debt on patients and families, including holding providers and debt collectors accountable for harmful actions. Part of the effort is a U.S. Department of Health and Human Services (HHS) initiative to evaluate how providers’ billing practices affect healthcare access and affordability along with the accrual of medical debt.

Categories: Reimbursement
March 28, 2022
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Keys to Maximizing Your Share of the Local Radiology Market

The pandemic was a significant challenge for many radiology practice groups. However, it also provided an opportunity for them to take an honest assessment of their operations and find ways to improve, innovate and maximize efficiencies to remain competitive and thrive in a post-pandemic climate. Radiology practice groups are seeing increased imaging demand as patients are catching up on missed care over the last two years. There are a few core questions practice leaders must ask themselves.

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March 2, 2022
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Four ways healthcare organizations can improve financial performance

Strong financial performance is essential for the success of healthcare organizations. To continue providing the best patient care while also improving financial performance, consider these four tactics.

February 11, 2022
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No Surprises Act: Expert insights to help doctors follow the law | American Medical Association

Implementation of the No Surprises Act, intended to protect patients from unexpected out-of-network medical expenses, will take a while. But there are things that doctors must know and do now to comply and be prepared as regulations are developed and put in place. 

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January 31, 2022
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Latest healthcare spending data paint a complicated picture of industry challenges and opportunities

Healthcare spending surged during the first year of the COVID-19 pandemic even as spending on direct care slowed significantly, according to new data. There are no easy solutions to make spending on hospital care more efficient within the current payment structure, a healthcare economist said. Public health should be a greater emphasis in healthcare spending policies, another expert said. Newly reported healthcare spending patterns from the first year of the COVID-19 pandemic reflect an industry trying to get its bearings amid both a public health emergency and daunting long-term trends. 

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January 5, 2022
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New surprise billing regulations: How providers should be preparing to fulfill the pending requirement about good-faith estimates

Providers have had a mere three months to implement the processes needed to comply with a new requirement to furnish uninsured patients with good-faith price estimates ahead of services. 

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December 6, 2021
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Healthcare industry leaders share ideas with CMMI for improving value-based payment models, with benchmarking a top concern

During a recent call with healthcare stakeholders, leaders with the Center for Medicare & Medicaid Innovation heard various ideas for improving value-based payment models. CMMI conducted the November call to get a better sense of how it can accommodate stakeholders as it seeks to implement a revamped vision for VBP models. 

Categories: Reimbursement
December 6, 2021
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New Exa Platform Functionality Automates Decision Support, Insurance-Related Tasks for Enhanced Productivity and Profitability

Konica Minolta Healthcare Americas, Inc., announced today new features and functionality for the Exa ® Platform that automate common clinical and administrative tasks. These new capabilities assist use of Appropriate Use Criteria (AUC) for advanced diagnostic imaging, supporting a Centers for Medicaid and Medicare Services (CMS) mandate, and eliminate inefficiencies in determining patient insurance eligibility and co-pay responsibility.

December 6, 2021
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2022 Physician Fee Schedule prompts praise, but also fear of ‘financial peril’

The CMS final rule regarding physician payment, clinical labor prices, critical care services and telehealth services for fiscal year 2022 has drawn mixed reactions from medical groups. Some of the rule’s components exacerbate concerns brought on by the COVID-19 pandemic while others alleviate them, the groups said.

Categories: Reimbursement

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