denials
publication date
Payer
'An Arm and a Leg': They Turned Grief Into ActionThis episode focuses on how New York enacted a charity care law, one of the precursors to the federal provision...
Payer
CMA Blasts Aetna "Pre-certified" Mandate for Cataract Surgeries California docs say the latest mandate is part of an ongoing and "common practice for health insurance companies to create...
Revenue Cycle
4 Dos and Don'ts for Managing Inpatient-to-Observation Status Downgrades In the newest episode of the HealthLeaders Revenue Cycle Podcast, Charlie Brown, MBA, a former hospital executive and vice president...
Payer
Contraception Is Free to Women, Except When It's NotDespite the ACA's guarantees of free contraception coverage, even for women whose health plans are subject to the law's requirements,...
Revenue Cycle
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,...
Revenue Cycle
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...
Revenue Cycle
United Healthcare Will Deny or Limit Coverage for ED Commercial Claims it Considers Non-EmergentThe new policy will apply to "commercial fully insured ED facility claims in many states for dates of service on...
Revenue Cycle
33% of Hospital Executives Say Their Average Denial Rates are More Than 10%The average national denials rate is between 6% and 13%, but many organizations are nearing the denials "danger zone" of...
Revenue Cycle
3 Great Strategies from the Revenue Cycle Ideas ExchangeThree top revenue cycle leaders share their proven strategies for price transparency, increasing revenue, and reducing denials during the HealthLeaders...
Revenue Cycle
How Hiring A Denial Management Registered Nurse for Rev Cycle Contributed to $6M ROIThe UM denials management nurse has helped the rev cycle recognize trends, gain better insight into the tactics payers use...
Revenue Cycle
Q&A: New UnitedHealthcare GuidelinesWhile UnitedHealthcare will provide organizations with criteria to make status decisions for patients, it will not provide hospitals with the...
Revenue Cycle
Using Denial Analysis DataPerforming denial analysis on a regular basis will enable you to identify the top reasons for denials and develop action...