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Claims Processing

In-depth

5 tips for attaining real-time claims

5 tips for attaining real-time claims

Real-time claims processing can result in financial benefits, so healthcare technophobes need to get on board.

Medicare claims crisis pits hospitals against feds, auditors

Medicare claims crisis pits hospitals against feds, auditors

The federal government and a number of hospitals may want to transition to a new Medicare…

Whitepapers

Scenario Planning for the Agile Healthcare Organization

Scenario Planning for the Agile Healthcare Organization

Scenario planning helps hospitals and healthcare providers manage uncertainty by providing alternative…

Navigating the Road to RAC Survival

Navigating the Road to RAC Survival

Centers for Medicare and Medicaid Services (CMS) reinstated the Recovery Audit program in late 2014, meaning that automated…

News

Medicare outpatients pay much more at critical access hospitals

Medicare outpatients pay much more at critical access hospitals

Many Medicare beneficiaries treated at primarily rural "critical access" hospitals end up paying between two and six times more for outpatient services than do patients at other hospitals, according to a report released Wednesday by the HHS inspector general.

Our Lady of the Lake sets up 'value guarantees,' stops charging for some post-op care

Our Lady of the Lake sets up 'value guarantees,' stops charging for some post-op care

Hospital does not charge for any additional care within 30 days of a hip or knee replacement, covering readmissions, infections, rehab and postoperative care — everything except deficiencies in the joint devices.

5 things to know about narrow network plans: Less choice, lower costs

5 things to know about narrow network plans: Less choice, lower costs

For example, among narrow network plans, median premiums are 10 percent higher for plans with an academic medical center than for those without.

Whitepapers

Credible, Defensible Estimates

Credible, Defensible Estimates

In healthcare, every interaction with the patient matters. Especially in today’s environment of continuous improvement, efforts have been concentrated on coordination among providers, the patient care experience and quality outcomes – all laudable goals.

Clinical Quality Measures 101

Clinical Quality Measures 101

Although quality-reporting programs such as meaningful use provide incentives to help providers implement and use electronic health records (EHRs) to collect and report on clinical data, practices often need help deciding what data to collect, which measures to…

Gaining Actionable Insight into Financial Systems and Areas Impacting the Revenue Cycle

Gaining Actionable Insight into Financial Systems and Areas Impacting the Revenue Cycle

Hospital systems across the country are looking to streamline their billing and collection processes to become more efficient and better compete in their markets. The challenge many face is how to turn the data that's already flowing through financial systems into…

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