payers
publication date
Revenue Cycle
Electronic Prior Auths Save Time, But Don't Change Approval RatesePA reduced the time between submitting a prior authorization request and receiving a decision from the health plan by 69%.
Revenue Cycle
Employers Have Healthcare Pricing on the BrainMore than half are considering pre-deductible coverage of chronic conditions and 45% anticipate increased employee cost sharing to mitigate cost...
Revenue Cycle
How a No-Huddle Offense Strategy Can Create Big Rev Cycle WinsInstead of always working on "high effort, high impact" projects, revenue cycle leaders should also focus on "low effort, high...
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
Policymakers Should Look to States for Surprise Billing Arbitration SystemResearchers from the Robert Wood Johnson Foundation examined independent dispute resolution (IDR) systems in four states that already use this...
Innovation
Virtual Care Key to Humana-Mercy Value-Based ContractMedicare Advantage contract between Humana and Mercy expands to offer patients access to Mercy Virtual services. The arrangement is part...
Strategy
What Will the 'Next Haven Healthcare' Look Like?Healthcare executives share their thoughts on how the next big disruptor will be perceived by the industry and the steps...
Revenue Cycle
What Rev Cycles Need to Know About the No Surprises ActThe No Surprises Act goes into effect January 1, 2022, and protects patients from surprise medical bills and establishes an...
Revenue Cycle
Arbitration It Is. But How to Decide Who Wins in Surprising Billing Disputes?A new Health Affairs study compares arbitration outcomes in New Jersey to relevant benchmarks.
Revenue Cycle
HonorHealth Teams with OODA Health, BCBS of Arizona Blue Cross Blue Shield of Arizona members who are treated by HonorHealth will be able to use the OODAPay platform...
Revenue Cycle
MGMA: It's Time to Reduce the Prior Authorization BurdenIn responding to an ONC task force draft report about clinical integration and reducing administrative burden in healthcare, Medical Group...
Revenue Cycle
6 Action Items for Your Denials Management PlanKimberly Scaccia, vice president of revenue cycle at Mercyhealth, outlines a methodical, multistep action plan for creating a denials management...