CMS Final Rule: Changes to the Medicare Advantage Program
Key changes promote transparency in coverage decisions for MA beneficiaries, while ensuring providers can offer the best care for patients. … Read More
May 3, 2023
Insights
Ideas, insights + industry updates
Cigna Reimbursement Policy Change: Office Notes Required to Bill E/M Service Separate from Same-Day Minor Procedure
New policy states any separately identifiable E/M service performed on the same day as a minor procedure must be submitted with office notes. … Read More
April 10, 2023
Tips for Successfully Engaging Employees During a Transition
Hear from two health system leaders about their experience with staff engagement through outsourcing. … Read More
March 28, 2023
How to Engage Employees + Ultimately Improve Patient Experience
Make employee engagement a top priority for the effect it will have on your employees as well as your patients and community. … Read More
February 28, 2023
4 Tips for Forming an Employee Advisory Group
Creating and effectively overseeing an EAG is can have a significantly positive impact on employee engagement, morale and company culture. … Read More
February 27, 2023
3 Tips to Successfully Negotiate Your Next Payer Contract
Providers must leverage what’s in their payer contract, comparative data and price transparency rules to level the playing field with payers. … Read More
February 27, 2023
Diagnostic Monitoring Services Under Increased Federal Scrutiny Following $45M Settlement
A cardiac monitoring company and its subsidiary agreed to a settlement with the DOJ following allegations they violated the False Claims Act. … Read More
February 24, 2023
CMS Proposes Updates to Medicare Advantage Utilization Management Policies + Overpayment Standards: Comments Due Feb. 13
CMS issued a proposed rule that could change utilization management and prior authorization criteria for Medicare Advantage plans. … Read More
January 30, 2023
Be Prepared for Increased Medicare Bad Debt Compliance Scrutiny
OIG and CMS agree more scrutiny is needed for Medicare bad debt reimbursement and encourage more regular review of bad debts claimed. … Read More
January 28, 2023
3 Ways to Dramatically Reduce Denials
With financial pressures increasing, providers can’t afford not to implement effective denial management and prevention strategies. … Read More
January 28, 2023