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publication date

Payer
Covenant Healthcare Paid $69M to Settle FCA Allegations
John Commins | March 30, 2023
Two physicians allegedly involved in the scheme to defraud Medicare, Medicare, TRICARE and other government payers will also pay a...
Finance
The Exec: CFO Kevin Murphy on the 'Fundamental Flaw' in Fee-For-Service Payments
Amanda Schiavo | March 20, 2023
'The fee-for-service model does not create a competitive dynamic in the fees that are charged broadly across the healthcare system,'...
Finance
Why Harold Miller Says Population-Based Payment Isn't the Silver Bullet Medicare Thinks
Amanda Schiavo | March 13, 2023
Very few hospitals are utilizing this payment system, but Medicare wants to change that.
Payer
Feds Move to Rein In Prior Authorization, a System that Harms, Frustrates Patients
Kaiser Health News | March 13, 2023
Few things about the American healthcare system infuriate patients and doctors more than prior authorization.
Payer
Providers, Not Just Payers, Push Back Against Medicare Advantage Pay Rule
Jay Asser | March 09, 2023
Both sides have raised concerns to CMS over the ramifications of the Medicare Advantage (MA) advance notice rule.
Revenue Cycle
The Exec: Building Patient Trust and ROI Through Bill Pay Tech
Amanda Norris | March 08, 2023
Drew Smith, director of revenue cycle at MainStreet Family Care, talks implementing text-based bill pay and creating a positive patient...
Revenue Cycle
As Payment Platforms Take Off For Patients, Rev Cycle Leaders Take Heed
Amanda Norris | March 02, 2023
There is an obvious need for patient payment platforms, but revenue cycle leaders aren't letting vendors off the hook.
Revenue Cycle
OIG IDs $216M in Possible Medicare Drug Testing Overpayments; CMS Rejects Claw Back
John Commins | March 01, 2023
CMS agrees that enhanced oversight is needed, but says OIG audit 'does not constitute credible information of overpayments.'
Payer
Medicare Advantage Enrollment Shot Up 337% as Payment Policy Fell Behind
Jay Asser | February 10, 2023
Plans have experienced exponential growth, but researchers caution that the outdated payment policy has ramifications.
Payer
Payers Paid Similarly for Telehealth and In-Person Claims in 2020
Jay Asser | January 27, 2023
New research investigates the financial impact of reimbursing telehealth services at parity with in-person care.
Revenue Cycle
A 600% Increase: No Surprises Act IDR Process is Officially Draining Your Rev Cycle's Bottom Line
Amanda Norris | January 19, 2023
The independent dispute resolution (IDR) process has gotten more expensive for healthcare organizations?by 600%.
Revenue Cycle
Big provisions in $1.7 trillion omnibus: What doctors should know
American Medical Association | January 16, 2023
In enacting the 4,000-plus page, end-of-the-year spending package, Washington politicians failed to stop the entirety of scheduled Medicare pay cuts,...
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