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publication date

Payer
Nearly 9 in 10 Medicare Advantage Members Satisfied with Coverage
Jay Asser | June 16, 2022
Findings in a recent survey of beneficiaries push back on criticism of the service's administration.
Revenue Cycle
Department of Justice Asked to Investigate False Claims Act Violations
Jay Asser | May 20, 2022
The American Hospital Association (AHA) is asking for the creation of a task force to look into improper denials by...
Revenue Cycle
AHA Wants 'Swift Action' Against Restrictive Medicare Advantage Plans
Jay Asser | May 20, 2022
CMS is urged to take steps to increase MA plan oversight and address issues raised in an OIG report.
Revenue Cycle
Rev Cycle Leaders: Focus on Unnecessary Medical Necessity Denials
Amanda Norris | May 17, 2022
A focus on front-end revenue cycle efficiency can help to avoid costly medical necessity denials.
Revenue Cycle
Medicare Advantage Prior Authorizations Are Often Unnecessarily Denied
Jay Asser | May 06, 2022
A report by the Office of Inspector General (OIG) raises concerns about organizations prioritizing profits over patient access to care.
Revenue Cycle
Measuring Revenue Cycle Health Through Denials Management
Amanda Norris | April 14, 2022
An organization's denial rate is a good barometer of its overall financial health and the soundness of its revenue cycle....
Revenue Cycle
Prior Authorization Less Likely to be Granted for Mental Health
Jay Asser | April 08, 2022
According to a study by the U.S. Government Accountability Office (GAO), patients face greater challenges with receiving approval for mental...
Revenue Cycle
AHA Wants Required Prior Authorization Waivers During PHEs
Jay Asser | March 16, 2022
The American Hospital Association (AHA) is asking to mandate waiving the administrative process during public health emergencies (PHE) as patients...
Payer
Stranded by the Pandemic, He Had Only Travel Insurance. It Left Him With a $38,000 Bill.
Kaiser Health News | November 18, 2021
Travel insurance generally covers only emergency or urgent medical expenses, according to the California state insurance commission, which regulates policies...
Payer
'An Arm and a Leg': Need Surgery to Save Your Life? Tips for Getting Insurance to Pay
Kaiser Health News | November 02, 2021
Laurie Todd calls herself the "Insurance Warrior." She helps people get their health insurance companies to pay for treatment and...
Human Resources
Opinion: The Pandemic Forced My Transgender Wife to Fight Our Insurer Over Hormones
Kaiser Health News | October 05, 2021
The COVID-19 pandemic has caused millions of people to lose their jobs and private health insurance, particularly LGBTQ adults.
Payer
'An Arm and a Leg': They Turned Grief Into Action
Kaiser Health News | September 21, 2021
This episode focuses on how New York enacted a charity care law, one of the precursors to the federal provision...
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