PayerCovenant Healthcare Paid $69M to Settle FCA Allegations
Two physicians allegedly involved in the scheme to defraud Medicare, Medicare, TRICARE and other government payers will also pay a...
FinanceThe Exec: CFO Kevin Murphy on the 'Fundamental Flaw' in Fee-For-Service Payments
'The fee-for-service model does not create a competitive dynamic in the fees that are charged broadly across the healthcare system,'...
FinanceWhy Harold Miller Says Population-Based Payment Isn't the Silver Bullet Medicare Thinks
Very few hospitals are utilizing this payment system, but Medicare wants to change that.
PayerFeds Move to Rein In Prior Authorization, a System that Harms, Frustrates Patients
Few things about the American healthcare system infuriate patients and doctors more than prior authorization.
PayerProviders, Not Just Payers, Push Back Against Medicare Advantage Pay Rule
Both sides have raised concerns to CMS over the ramifications of the Medicare Advantage (MA) advance notice rule.
Revenue CycleThe Exec: Building Patient Trust and ROI Through Bill Pay Tech
Drew Smith, director of revenue cycle at MainStreet Family Care, talks implementing text-based bill pay and creating a positive patient...
Revenue CycleAs Payment Platforms Take Off For Patients, Rev Cycle Leaders Take Heed
There is an obvious need for patient payment platforms, but revenue cycle leaders aren't letting vendors off the hook.
Revenue CycleOIG IDs $216M in Possible Medicare Drug Testing Overpayments; CMS Rejects Claw Back
CMS agrees that enhanced oversight is needed, but says OIG audit 'does not constitute credible information of overpayments.'
PayerMedicare Advantage Enrollment Shot Up 337% as Payment Policy Fell Behind
Plans have experienced exponential growth, but researchers caution that the outdated payment policy has ramifications.
PayerPayers Paid Similarly for Telehealth and In-Person Claims in 2020
New research investigates the financial impact of reimbursing telehealth services at parity with in-person care.
Revenue CycleA 600% Increase: No Surprises Act IDR Process is Officially Draining Your Rev Cycle's Bottom Line
The independent dispute resolution (IDR) process has gotten more expensive for healthcare organizations?by 600%.
Revenue CycleBig provisions in $1.7 trillion omnibus: What doctors should know
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,...