UNITED HEALTHCARE WILL DENY OR LIMIT COVERAGE FOR ED COMMERCIAL CLAIMS IT CONSIDERS NON-EMERGENT
The new policy will apply to "commercial fully insured ED facility claims in many states for dates of service on July 1, 2021, or later."
4 REASONS WHY UNITEDHEALTHCARE'S ATTEMPT TO 'MONDAY MORNING QUARTERBACK' ED CLAIMS IS 'BAD POLICY'
"It really undermines what the physicians are doing at the point of care, and it's bad policy," says Doug Wolfe, co-founder and partner of the Miami-based law firm Wolfe Pincavage.
WHAT REV CYCLES NEED TO KNOW ABOUT THE NO SURPRISES ACT
The No Surprises Act goes into effect January 1, 2022, and protects patients from surprise medical bills and establishes an independent dispute resolution process for payers and providers.
EMERGENCY PHYSICIANS CALL UNITED HEALTHCARE'S ED DENIAL POLICY 'DANGEROUS'
The American College of Emergency Physicians said that it "firmly believes that the new policy is in direct violation of the federal Prudent Layperson Standard."
NO SURPRISES ACT PROVISION DELAYED
HHS said it would defer the good faith estimate requirement for insured patients "until rulemaking to fully implement this requirement…is adopted and applicable."
PROVIDER STAKEHOLDERS TO UNITEDHEALTHCARE: A DELAY ISN'T ENOUGH
Nearly a week after UnitedHealthcare backed off its decision to retroactively deny emergency care claims, provider groups are still hitting back.
PRICE TRANSPARENCY IS HERE. 2 COMMUNICATION ACTIONS TO TAKE
Complying with the CMS price transparency mandate is only the first step. Hospitals should also ramp up their communication efforts and finally answer the question for patients: "What do I owe?"
5 AREAS WHERE ASCENSION HAS CREATED A SEAMLESS CONSUMER FINANCIAL JOURNEY
'We don't think about revenue cycle as any one individual's responsibility, but as our organization's responsibility,' says Jon Sohn, senior vice president and chief revenue officer for Ascension.
4 TAKEAWAYS FROM THE FIRST DAYS OF THE CMS PRICE TRANSPARENCY RULE
Becky Greenfield, a partner with Wolfe Pincavage, provides an early temperature check on hospital compliance with CMS' price transparency mandate for hospitals.
UP YOUR CODING GAME TO BETTER LEVERAGE SDOH
Healthcare organizations can assure the availability, integrity, security, and usability of SDOH data through data governance, says AHIMA.