Billing and Collections

As more new patients come into the healthcare system, savvy providers are seeing opportunities to develop better relationships with the hope that it will translate to greater bill collection success.

For many Americans, the ACA open enrollment period offers them an opportunity to have health insurance for the first time. But for hospitals and healthcare organizations, ACA open enrollments create financial and operational challenges.

Hospitals' struggle for financial sustainability continues and may be getting worse, as CFOs say information technology investments draw more resources than expected and threaten to crowd out other priorities.

It's the rare hospital that has never experienced delays in receiving reimbursement as a result of clinical documentation coding snafus. But hospitals that don't make a serious stab at clinical documentation improvement (CDI) will be poised to take an even harder hit come October 2015, the start date for ICD-10 implementation.

While some health systems are reluctant to publish prices without reforms of insurance practices and proper context for patients, some are trying to embrace transparency as a new model. Washington State's Everett Clinic is one of those pioneers.

It's never been more difficult for healthcare providers to collect payment for services provided. These recommendations will help you get the most from your efforts and avoid costly mistakes.

Commercial insurers inaccurately process about 20 percent of claims filed by medical practices. It's an industry standard that has weathered the test of time -- though not in a good way.

Significant inpatient pricing variation between hospitals in the state of Washington is "putting some consumers at financial risk," according to a recent study by the Washington Health Alliance. But the state's hospitals are questioning the report's conclusions, claiming that price variation should not be surprising.

Many Medicare beneficiaries treated at primarily rural "critical access" hospitals end up paying between two and six times more for outpatient services than do patients at other hospitals, according to a report released Wednesday by the HHS inspector general.

A program that combines a mobile app, analytics and direct intervention is showing promise in reducing the costs associated with hospitals' most expensive patients -- the so-called "super-utilizers."