denial management

Each year millions of patients continue to face denials through the prior authorization process.

To proactively address claim denials, Wellstar Health System organizes monthly, cross-functional meetings that bring clinical and revenue cycle teams together...

From simplifying EHR systems to embedding clinical expertise, revenue cycle leaders are rewriting the playbook to combat aggressive payers and...

While the number of Advantage plans owned by hospital systems is relatively stable, Mass General Brigham in Boston and others...

A tiny tick bite exposes how prior authorization can apply to inexpensive and medically necessary treatments.

Bill Arneson of Moffitt Cancer Center explains how an AI tool for medical necessity appeals cut the cost to work...

The pilot program, designed to weed out wasteful, 'low-value' services, expansion the federal use of prior authorization.

Nearly one-in-five hospitals faced at least one case of public brinksmanship with payers over the past five years.

For CFOs, the report is both a spotlight on improved performance and cautious reminder of where challenges still lie.

As financial pressures grow, CFOs are eyeing Direct Primary Care as a more stable, patient-focused alternative?though not without risks and...

The volume of commercial payer claim denials continues to rise and the appeals process has slowed, according to a new...

Trump administration officials applauded the insurance industry for its willingness to change, but also acknowledged limitations of the agreement.