The art of successfully negotiating payor contracts, is critical in navigating today’s healthcare environment of rising costs, increased regulatory scrutiny, and shrinking reimbursement rates and margins; and laying the ...
835 PAYMENT ANALYSIS: DIAGNOSTICS AND CHECKUPS So do you really know what you are being paid? That is the burning question for many health care executives and revenue cycle leaders. You’re seeing that magic number each month in ...
Updates to the Price Transparency of Hospital Standard Charges occur within the 2022 CMS Final Rule, but what does this mean for hospitals? If appropriately addressed, it could translate to an advantage. Highlights of the change ...
Synchronizing cultures, IT systems, employee staffing, and clinical care requires a monumental effort. Moreover, it absorbs 110% of everyone’s time. Aligning charges within multiple and different systems is many times left to a ...
Have you evaluated your third-party payor contracts lately? Do you have any contracts coming up on renewal? Have you compared payments across payors for consistency and adequacy relative to costs across service areas? Do you have ...
It is essential to prepare for upcoming changes to outpatient prospective payment systems and classification to the Inpatient-Only listing of services by assessing the procedures performed in your operating room along with its ...
The principle of transparency is a good thing for most businesses. It ensures that honesty and accuracy are paramount in the day-to-day dealings of a company. Hospital pricing transparency is a case in point. Our team at MedCom ...
Sometimes it’s easy to overlook what should be apparent to us. We can be too close to something and fail to see the big picture. It’s true for a lot of topics, and the health business is no different. That is why it always pays ...
PURPOSE: Promote the ordering of the most appropriate test for the patient using evidence-based criteria; Utilize data collected to identify outlier ordering providers who will become subject to CMS prior authorization for ...
The operating suite is the biggest driver for revenue at a hospital. An average of 65 percent of income flows through the OR. That is the prime reason why it’s essential to have accurate OR charge analysis at your facility. ...
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