Claims Processing

One thing that strikes fear into the hearts of many physicians is the impending switch from ICD-9 to ICD-10, but experts say preparation and planning should keep their accounts receivable from stalling altogether.

According to a revenue cycle management study released by market researcher Black Book, 72 percent of physician practices expect declining to negative profitability next year because of underutilized or inefficient billing technology.

With implementation of the Affordable Care Act fast approaching, the eligibility process could be queuing up for an overhaul.

The Centers for Medicare & Medicaid Services has recommended that hospitals start testing for ICD-10 in 2013, but so far, many have not heeded that recommendation. That mistake could ultimately hit hospitals in the wallet.

State-of-the-art revenue cycle technologies can not only speed up the claims submission and payment process, but also make the lives of business office staff much easier. Here are 4 key technologies that help providers collect what they're owed.

Medians for U.S. not-for-profit healthcare systems remained steady in 2012, but analysts expect a weakening in ratios due to the pressures of healthcare reform.

As medical supply prices have steadily risen in recent years, many hospitals have turned to group purchasing organizations to buy in bulk and keep costs down, but group product purchasing also complicates the product supply trail, often leading to errors that prevent fulfillment, delivery and payment.

Several key trends are reshaping the business strategies of health insurers in advance of the Jan. 1 go-live date for many provisions of the Affordable Care Act.

The trend of providers owning health plans took a big step forward in New York last week when the state approved North Shore-LIJ Insurance Company's application for an insurance license.

Errors in manual claims processing are a big problem. While underpayments lead to complaints and rework, overpayments may go unnoticed and cost far more.