Revenue Cycle Insights June 2022
Hospital pricing and surprise billing remain hot topics, with Senior Editor Nick Hut outlining some recent reports on the subject. And Jonathan Blum, of CMS, describes how the industry is reacting to the agency’s new regulations of price disclosure and surprise billing, in a podcast with Joe Fifer, CEO of HFMA.
Texas-based study raises questions about impact of using additional criteria in No Surprises Act arbitration cases
Study results indicate that ongoing litigation over the independent dispute resolution process established by the No Surprises Act may not have a major impact on outcomes.
Healthcare News of Note: InstaMed report says 87% of consumers were surprised by a medical bill in 2021
Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Surprise medical bills were prevalent in 2021, long-haul COVID in the United States is in the news, and a report identifies America's most segregated hospital markets.
Insurer groups issue report showing the No Surprises Act’s early impact on patient billing
More than 2 million potential surprise medical bills were prevented during the first two months of the No Surprises Act, according to the health insurance lobby.
Leveraging artificial intelligence to advance organizational strategy
When bringing artificial intelligence into their business models, health systems have the opportunity to improve revenue cycle management by maximizing efficiencies. With the potential to improve workflow and consolidate resources, automation and machine learning require organizations to examine their infrastructure, from staffing to datasets. Investing in automated processes to reduce variation and empower staff to…
No Surprises Act
As a result of the 2021 Consolidated Appropriations Act, several No Surprise Billing Act regulations will go into effect on Jan. 1, 2022 for providers, facilities and air ambulance services. These requirements include prohibitions on balance billing for certain items and services, consumer notification and consent requirements for insured patients, cost sharing rules and disclosures, and uninsured/self-pay good faith estimate requirements for scheduled or shoppable items and services.
Big delays could be in store for early No Surprises Act arbitration cases
The portal for payment arbitration cases taking place under the No Surprises Act is open for business but could be facing a backlog of cases.
Strategic alternative dispute resolution offers providers key to substantial claim recoveries
To be able to effectively handle disputes over healthcare claims, providers must be well-informed about the two basic types of alternative dispute resolution that can help them achieve favorable results: arbitration and mediation.
A best-practice approach to coding, coding quality and compliance improves reimbursement
Healthcare providers need to ensure they are accurately paid for the care provided, and that starts with timely, correct and consistent coding. This critical revenue cycle process codifies the clinical care performed and documented.
Tentative deal to provide pandemic funding won’t replenish the COVID-19 Uninsured Program
A bipartisan Senate bill would pay for additional vaccines and therapeutics but wouldn’t restore funding to a program that reimburses providers for furnishing COVID-19-related services to the uninsured.