Revenue CycleHow Health Insurers Have Made Appealing Denials So Complicated
Health insurers reject millions of claims for treatment every year in America. Corporate insiders, recordings, and internal emails expose the...
Revenue Cycle2024 CPT Code Set Released: 5 Key Takeaways
There are over 300 changes you need to know.
Revenue CycleFirst Wave of UHC Prior Auth Cuts Begin, But Will it Matter?
In an effort to soften the payer/provider relationship, many large health insurers are rolling back on prior authorizations.
Revenue CycleCigna Sued for Allegedly Using Algorithm to Deny Claims
The health insurer's PXDX system rejected coverage for "hundreds or thousands [of claims] at a time," the lawsuit states.
PayerMedicaid Managed Care Has High Rates of Prior Authorization Denials
A report by the Office of Inspector General (OIG) finds Medicaid managed care members may not be receiving all medically...
Revenue CycleExperts Weigh in on The Future of Rev Cycle Payer Audits
Payer scrutiny won't be letting up anytime soon, in fact, expect it to intensify.
PayerHow Often Do Health Insurers Say No to Patients? No One Knows.
Insurers' denial rates ? a critical measure of how reliably they pay for customers' care ? remain mostly secret to...
Revenue CycleMost-Read Revenue Cycle Articles in Q2 2023
Check out the most-read revenue cycle articles from the past quarter.
PayerHow Prior Authorization in Medicare Advantage is Harming Everyone
Even for insurers, the administrative process in the private program has drawbacks that may not be worth the cost savings.
Revenue CyclePerspective: Denials of Health Insurance Claims Are Rising — And Getting Weirder
Denials have become another predictable, miserable part of the patient experience.
Revenue CycleAre Commercial Payers to Blame for Majority of Rev Cycle Claim Denials, Payment Delays?
One study says yes.
Revenue CycleLeaders Agree, The Revenue Cycle Needs More Denials Management Expertise
Hundreds of leaders were asked which rev cycle tasks require the most subject matter expertise.