- Community Hospitals
- Health Plans
Hospital monopolies ruin MRI bill as Sutter gets price it wants
After Mark Logsdon tore a ligament in his knee skiing at Lake Tahoe in March, he returned home to suburban Sacramento...
RAC Provisions Putting CMS, Providers at Odds
In response to feedback from the RACs, providers, suppliers, and their associations, CMS recently expanded its fiscal...
New Issues Highlight Need for RAC Strategy
Last December, the first sets of complex RAC review issues were released. Since then, the list has grown, as each RAC...
Four Ways to Untangle RAC's Medically Unlikely Edits
Connolly Healthcare and CGI recently added Medically Unlikely Edits for outpatient hospital claims to its CMS-approved...
Donors Shift Giving Patterns in Rough Economy
Businesses and individual donors hit hard by the recession have shifted charitable giving patterns to longer-term...
RAC Begins Complex DRG Validation Audits
Connolly Healthcare has announced the first issues approved for complex RAC review, so providers in several RAC Region...
Senate Reform Bill Would Expand RAC Program
The Senate health reform bill would broaden the current RAC program to cover Medicare Part C and D as well as the...
House Passes Red Flag Exemption for Small Practices
The House of Representatives unanimously passed a bill Tuesday, October 22, that would exempt a healthcare practice...
Escalating Medicare and Medicaid Auditing on the Horizon
It's no longer just RAC, MAC, CERT, and ZPIC audits looking to ensure the accuracy of Medicare payments. Providers are...
Hospitals Still Not Over the Hump
Despite the positive news from a Thomson Reuters study last week, which found that hospital margins had rebounded in...
Book: The Healthcare Executive's Guide to Urgent Care Centers and Freestanding EDs
One in five Americans lacks adequate access to primary care physicians and even those patients with insurance and a...