News

Cincinnati, Ohio, – Sept. 21, 2023 – Ensemble Health Partners (“Ensemble”), the leading revenue cycle management company for hospitals, health systems and physician practices, received the top score for overall performance among end-to-end revenue cycle outsourcing vendors in KLAS Research’s End-to-End Revenue Cycle Outsourcing (“RCO”) 2023 Performance Report.

The stated goal of this bill is to prevent HOPD rates from being paid for services rendered in free-standing physician offices or other settings that should be reimbursed at a lower cost. There is also speculation the bill might be the first step in a larger reimbursement model overhaul aimed at aligning HOPD reimbursement rates with those of ASCs and physician practices.

On April 5, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that requires Medicare Advantage (MA) plans to follow traditional Medicare laws for coverage decisions, limits the use of prior authorization, mandates continuity of care for Medicare beneficiaries and establishes a Utilization Management (UM) Committee with a heightened standard for adverse medical necessity decisions. 

This is the fifth year in a row that Ensemble and its clients were recognized Cincinnati, Ohio (June 25, 2023) – Ensemble Health Partners, an industry-leading revenue cycle management company, in support of three healthcare provider clients, has been named a recipient of three 2023 MAP Awards for High Performance in Revenue Cycle, sponsored by

This marks the fourth consecutive year that Ensemble’s service has been top-rated for client experience and satisfaction in the annual survey. Cincinnati, Ohio, June 8, 2023 – Ensemble Health Partners (Ensemble) has been named the top ranked End-to-End RCM Outsourcing Service for Hospital Chains, Systems, Corporations and Integrated Delivery Networks, as well as the best End-to-End RCM

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.

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.

Submitting office notes with all claims using modifier 25 to indicate a separately identifiable E/M service and minor procedure means providers and revenue cycle professionals will spend more time and resources billing these claims.

CMS is accepting comments until March 13 on its proposed rule to improve interoperability between payers and providers and eliminate barriers in the prior authorization process that put undue burden on providers and potentially put patients at risk.

A cardiac monitoring company and its subsidiary agreed to a $44.9 million settlement with the Department of Justice (DOJ) following allegations they violated the False Claims Act (FCA) by billing federal programs for heart monitoring services that were knowingly performed outside the US. by unqualified technicians.