denials
publication date
Payer
Nearly 9 in 10 Medicare Advantage Members Satisfied with CoverageFindings 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 ViolationsThe 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 PlansCMS 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 DenialsA focus on front-end revenue cycle efficiency can help to avoid costly medical necessity denials.
Revenue Cycle
Medicare Advantage Prior Authorizations Are Often Unnecessarily DeniedA 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 ManagementAn 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 HealthAccording 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 PHEsThe 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.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 PayLaurie 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 HormonesThe 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 ActionThis episode focuses on how New York enacted a charity care law, one of the precursors to the federal provision...