Revenue Cycle

Q&A: New UnitedHealthcare Guidelines
While UnitedHealthcare will provide organizations with criteria to make status decisions for patients, it will not provide hospitals with the...
CMS Issues Reminder on MSP Billing Rules, Appeal Options
Organizations are required to determine whether Medicare is the primary or secondary payer prior to submitting a claim.

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Georgia Healthcare Provider Suffers Breach Affecting 79,000 Individuals
In a security notice posted on its website, Gore Medical Management said it was the victim of a data breach...
Healthcare cost savings
Bundled Payment Program Yields Big Savings for Commercially Insured Patients
There was an average savings of $16,144 per procedure when the surgery was performed through the Carrum Health program.
Capping Private Insurance Payouts to Medicare Rates Would Cut Healthcare Spending by $350B
However, hospitals, physicians and other providers would bear the brunt of the cuts.
Q&A: Conducting Chargemaster Audits
Revenue integrity staff will typically collaborate with the compliance department on audit activities.
OIG Report: Increased Medicare Spending on Inpatient Stays Raises Upcoding Concerns
The OIG reviewed Medicare Part A claims for inpatient stays from fiscal years 2014 to 2019 and found the number...
New opportunities for value-based care with HHS finalization of Stark Law, Anti-Kickback Statute, and Civil Monetary Penalties law reforms
Philly hospitals must now disclose prices for care, but it's still hard to comparison shop: 'The randomness is stunning.'
The price transparency requirement is supposed to help consumers save money on health care, but the presentation of the information...
The $1.9 trillion stimulus bill would make health insurance more affordable for millions
Renown Health pays $75K to settle right-of-access violation under HIPAA
Renown Health, P.C., a non-profit health system in Nevada, settled with the U.S. Office for Civil Rights at the U.S....
Congress has a new way to push states to expand Medicaid. Will it work in NC?
Opinion: RAND's recommendation for reducing healthcare spending isn't right or realistic
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