PayerNearly 9 in 10 Medicare Advantage Members Satisfied with Coverage
Findings in a recent survey of beneficiaries push back on criticism of the service's administration.
Revenue CycleDepartment of Justice Asked to Investigate False Claims Act Violations
The American Hospital Association (AHA) is asking for the creation of a task force to look into improper denials by...
Revenue CycleAHA Wants 'Swift Action' Against Restrictive Medicare Advantage Plans
CMS is urged to take steps to increase MA plan oversight and address issues raised in an OIG report.
Revenue CycleRev Cycle Leaders: Focus on Unnecessary Medical Necessity Denials
A focus on front-end revenue cycle efficiency can help to avoid costly medical necessity denials.
Revenue CycleMedicare Advantage Prior Authorizations Are Often Unnecessarily Denied
A report by the Office of Inspector General (OIG) raises concerns about organizations prioritizing profits over patient access to care.
Revenue CycleMeasuring Revenue Cycle Health Through Denials Management
An organization's denial rate is a good barometer of its overall financial health and the soundness of its revenue cycle....
Revenue CyclePrior Authorization Less Likely to be Granted for Mental Health
According to a study by the U.S. Government Accountability Office (GAO), patients face greater challenges with receiving approval for mental...
Revenue CycleAHA Wants Required Prior Authorization Waivers During PHEs
The American Hospital Association (AHA) is asking to mandate waiving the administrative process during public health emergencies (PHE) as patients...
PayerStranded 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 Pay
Laurie Todd calls herself the "Insurance Warrior." She helps people get their health insurance companies to pay for treatment and...
Human ResourcesOpinion: The Pandemic Forced My Transgender Wife to Fight Our Insurer Over Hormones
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
This episode focuses on how New York enacted a charity care law, one of the precursors to the federal provision...