Support Act Creates New Bundled Opioid Treatment Payments

January 8, 2020

Patti Lewis

Hospitals on the front lines of the opioid epidemic have new tools to address the scourge of opioid misuse and addiction, including bundled Medicare reimbursements for holistic treatment services.
On Jan. 1, 2020, a bundled Medicare payment became available to hospitals to support comprehensive treatment of opioid disorders. The new reimbursement opportunity is one of several provisions in the act aimed at mitigating opioid misuse risk among Medicare beneficiaries.

Ready to Meet PAMA Outreach Lab Reporting Requirements?

December 18, 2019

Monica Lelevich

Hospitals nationwide are scrambling to comply with a new reporting mandate announced by Medicare in early 2019 within a densely written and widely misunderstood transmittal. The reporting, which is mandated by PAMA, requires applicable hospital outreach laboratories and physician clinics that perform specimen-only lab testing to report their commercial payor payment rates for lab services by the end of March 2020 or potentially face fines of more than $10,000 per day.

3 Strategies for Reducing Non-clinical Healthcare Spending Waste

November 20, 2019

Jon Giuliani

Waste in the U.S. healthcare system has decreased slightly over the past eight years, but it remains an enormous problem, consuming 25% of all healthcare dollars. Cutting systematic waste in the areas of pricing and administrative complexity while reducing the risk of costly fraud, waste and abuse audits requires an approach grounded in empirical evidence and supported by a capable staff and advanced technologies. Learn how healthcare organizations can use external expertise to help reduce healthcare waste.

EHRs Underperforming on RCM

November 5, 2019

Jon Giuliani

With the majority of hospitals and health systems struggling to achieve the full potential of their electronic health systems (EHR), a recent survey found 46% of respondents are collaborating with external organizations, including outsourcing and vendor partnerships, to decrease revenue cycle costs and increase economies of scale.

All Eyes on Pricing Transparency

October 24, 2019

Randi Brantner

Pricing transparency has moved to the forefront of healthcare reform efforts. Meeting the challenges of pricing transparency demands a systematic approach grounded in empirical evidence and a capable staff implementing proven solutions.

Cash Injection: Accurate Coding for Vaccines Requires Precision, Attention to Detail

October 1, 2019

Patti Lewis

From flu to tetanus, vaccines are among the most common outpatient procedures providers administer on a day-to-day basis. But they can also be complex to code and bill, and undetected mistakes can result in continual underpayment for services rendered.

HITRUST Vendor Certification Boosts Cybersecurity

September 17, 2019

Matt Teagarden

Despite widespread industry determination to bolster healthcare information security, the number of health data cyberbreaches continues to explode nationwide, causing chaos for providers and payers and putting millions of patients at risk for identity theft. Learn how HITRUST certification can help.

How to Solve Healthcare’s Accounts Receivable Problem

September 6, 2019

Jackie Drees

Overall cost reduction and efficiency are some of the top financial priorities for today’s health system CEOs and CFOs. Faced with problems like shrinking revenue and increasing expenses, executives should start employing technological solutions, such as intelligent automation, to handle claims, increase efficiency and expedite insurance recovery.

Uncertainty Clouds Two-Midnight Rule; Poses Ongoing Denial Risk

August 23, 2019

Monica Lelevich

Difficult and sometimes treacherous for ships at sea, navigating in the dark can be equally perilous for hospitals struggling to comply with Medicare’s murky two-midnight inpatient admissions rule. To minimize two-midnight denials and optimize collections, hospitals need to have a concise understanding of how the rule works.

Physicians Seek Reprieve from Prior Authorization Burden

August 7, 2019

Dan Low

For physicians, being forced to obtain insurance company prior authorization before providing or ordering a specific treatment probably feels a lot like needing a permission slip from your parents in high school. Not only does the process cause frustration and resentment, it can also lead to treatment delays and substandard care. Five areas of improvement have been identified and are now the basis for proposed federal legislation.