Skip to main content

Claims Processing

By Stephanie Bouchard | 09:57 am | October 11, 2012
The Medicare program could save billions in the next decade if care models are restructured says a newly released analysis commissioned by a nonprofit, national consortium of home healthcare organizations.
By Kelsey Brimmer | 09:46 am | September 25, 2012
Hospital Corporation of America (HCA) Inc., the parent company of Parkridge Medical Center in Chattanooga, Tenn., and Nashville, Tenn.-based HCA Physician Services, has agreed to pay the U.S. Department of Justice $16.5 million to settle claims that it violated the False Claims Act and the Stark Statute in 2007.
By Steff Deschenes | 08:39 am | September 24, 2012
Organizations are beginning to recognize the importance of value-based purchasing. One industry expert offers three strategies for getting started immediately and making the most of this new payment model.
By Stephanie Bouchard | 09:30 am | September 18, 2012
If you're not using workpooling to distribute work, you may be losing money. That's the message attendees of the Maine chapter of the Healthcare Financial Management Association's annual conference in Rockport, Maine heard last week during a session on work productivity.
By Kelsey Brimmer | 10:26 am | September 04, 2012
According to the latest RACTrac survey by the American Hospital Association (AHA), Medicare recovery auditors (RAC)-related denials in the second quarter of 2012 soared upwards by 24 percent from the first quarter of 2012.
By Tom Sullivan | 09:28 am | August 28, 2012
A corner of the healthcare industry publicly asked the Department of Health and Human Services (HHS) to consider jumping directly to ICD-11. Here's a look at the reasons why this option was not selected by HHS.
By Kelsey Brimmer | 09:33 am | August 16, 2012
Earlier this month, the Mayo Clinic agreed to settle claims by the U.S. Department of Justice that the Rochester, Minn.-based healthcare system falsely billed Medicare and Medicaid for surgical pathology services that were not provided.
By Steff Deschenes | 02:44 pm | August 14, 2012
There's a tremendous amount of waste occurring in the healthcare industry. Organizations are moving to lean management because it exposes what and where these wastes are and rethinks the way work is done via value streams. Healthcare Finance News talked to a lean management expert to take a look at how waste impacts organizations.
By Steff Deschenes | 10:08 am | August 09, 2012
Despite all the innovations in the healthcare industry, the sad truth is that errors with wrongly prescribed medication are happening more than ever. Not only can this be costly for healthcare organizations, it can also have tragic consequences.
By Chris Anderson | 03:44 pm | August 08, 2012
While many private payers across the country have rushed to launch payment initiatives wrapped around healthcare delivery models like ACOs and patient-centered medical homes (PCMH), Washington-based Premera Blue Cross has found success via its unique payment model it calls Global Outcomes Contracting.