As hospitals continue to face unprecedented levels of financial pressure, leaving money on the table isn’t an option. Yet too many hospitals continue to lose anywhere from 1% to 10% of net revenue on underpaid claims each year – money they are contractually owed.
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With one in three hospitals expected to continue operating with a negative margin, leaving money on the table is not an option, but it’s a billion-dollar issue.
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Epic’s self-pay credits redistribution and automatic self-pay refund requests features could save valuable staff time and enhance patient satisfaction.
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Three steps to begin removing barriers and building an effective and proactive communications strategy between pre-access and referring providers.
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In our busy lives, we often tend to neglect our mental health needs because they may not be as apparent as our physical needs, or we may not prioritize them as highly. Starting with a healthy mindset about the importance of mental health is essential.
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The recent decision by Cigna to administratively deny claims lacking corresponding CPT/HCPCS codes for revenue codes 270-279 is not expected to have a significant impact on revenue. However, this change does raise some administrative concerns, particularly for providers operating under percent-of-charge payment agreements with Cigna.
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In summary, this new rule introduces several key changes that will promote transparency and consistency in healthcare coverage decisions for MA beneficiaries, while ensuring healthcare providers are able to provide the best possible care to their patients.
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Since 2020, states were prohibited from performing routine Medicaid eligibility redeterminations or disenrollment to receive the 6.2% increase in federal Medicaid funding during the public health emergency (PHE). However, on March 31, the Biden administration ended this continuous coverage requirement in anticipation of the PHE coming to an end on May 11.
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