Billing and Collections
The American Hospital Association is asking federal Medicare leaders to stem the practice of using sample hospital audit data to extrapolate overpayments eligible for recovery. The lack of clarity regarding standards for short patient stays has clouded the issue.
The federal government and a number of hospitals may want to transition to a new Medicare reimbursement model. But there are still billions of dollars in disputed fee-for-service claims waiting to be settled, sowing animosity between health systems and the feds.
A new interpretation of a 40-year-old law could offer healthcare providers more options for appealing payer recoupments or preventing them altogether.
The Affordable Care Act has created some new realities for hospitals when it comes to billing and collecting from patients. Hospitals are adjusting by instituting a variety of processes.
All but five states received a failing grade this year on the way they provide healthcare price transparency, according to a report by Catalyst for Payment Reform and the Health Care Incentives Improvement Institute.
Medicare's Trust Fund has a 12 years of solvency left and seniors are also being forced to pay more, making it a ripe time to reform today's haphazard payment system, argues Medicare's independent advisor.
The financial impact of the two midnights rule remains an open question and so is whether recovery auditors will challenge fewer claims or just shift their focus.
To compete in an increasingly consumer-centric business environment, healthcare providers must develop pricing and billing matrices that explain in detail the type of services rendered and the assigned amounts.
Despite the hassle of auto-cancellations, many home healthcare agencies find it difficult to keep track of their requests for anticipated payment.
Healthcare is one of the last bastions of consumer-unfriendly billing and pricing. As individuals start to take on more responsibility for premiums, deductibles and co-pays, they are increasingly demanding more transparency. And providers will be forced to respond.