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
Insights
Ideas, insights + industry updates
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
OIG Advisory Opinion: Providing Nurse Practitioner Services for Referring Physicians Poses Minimal Anti-Kickback Risk
The OIG issued an Advisory Opinion on nurse practitioners providing services that are traditionally performed by primary care physicians. … Read More
January 25, 2023
Beyond the Payment Variance Report
Experts share common issues that lead to costly underpayments as well as effective resolution strategies leveraged across 200+ hospitals nationwide. … Read More
January 10, 2023
5 Reasons Why RCM Outsourcing May Be Right for You
Using a third party can help you save money and time while letting you focus on what you do best — patient care. … Read More
December 30, 2022
Hospitals Ending 2022 in Red, Payers in Green
Hospitals are under unbearable financial pressure, many collapsing under their own weight while payers are raking in profit. … Read More
December 6, 2022
Insights from Health System CEOs + CFOs on Where We Go from Here
It’s time to redefine healthcare. Read three key strategies hospital executives are exploring (or should be) to survive the mounting pressure. … Read More
December 6, 2022