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Claims Processing

By Rene Letourneau | 12:48 pm | March 26, 2012
On average, roughly 10 percent of all healthcare claims are initially denied and require additional work on the part of the provider to secure payment. One industry expert offers a three-part plan for reducing the impact of denials on the revenue cycle.
By Kelsey Brimmer | 04:20 pm | March 22, 2012
On Thursday, Health and Human Services (HHS) Secretary Kathleen Sebelius announced that health insurance premium increases in nine states have been deemed "unreasonable" under the rate review authority granted by the Affordable Care Act.
By Kelsey Brimmer | 10:44 am | March 20, 2012
With the second anniversary of the Affordable Care Act (ACA) approaching, new data shows that more than 5.1 million seniors and people with disabilities on Medicare saved over $3.2 billion on prescription drugs because of the new healthcare law.
By Kelsey Brimmer | 10:50 am | March 14, 2012
The owner and operator of a Broward County, Fla.-area halfway house was sentenced Tuesday to 24 months in prison for his role in a Medicare fraud kickback scheme that funneled patients through a fraudulent mental health company.
By Kelsey Brimmer | 10:33 am | March 12, 2012
In an effort to standardize financial transparency for nonprofit and for-profit hospitals in New Jersey, the state's Senate's Health Committee approved a bill that would require for-profits to publicly disclose the same financial information that nonprofit entities must file with the Internal Revenue Services.
By Ulrich Brechbühl | 03:45 pm | March 09, 2012
The message is getting through to healthcare organizations: screening self-pay patients for Medicaid, Social Security Disability Insurance (SSDI) and other programs is necessary given today’s economic environment.
By Diana Manos | 12:01 pm | March 09, 2012
A computer glitch has resulted in Maine potentially covering 19,000 residents with Medicaid benefits who are no longer eligible to receive coverage.
By Rene Letourneau | 10:44 am | March 05, 2012
Health and Human Services Secretary Kathleen Sebelius announced today that the health reform law has eliminated lifetime limits on coverage for more than 105 million Americans.
By Rene Letourneau | 05:30 pm | February 16, 2012
Fifty-seven percent of private health plan payers are hesitant to accelerate the adoption of bundled payment without positive provider feedback, according to a recent poll from healthcare IT and research firm Gantry Group, LLC.
By Chris Anderson | 11:46 am | February 02, 2012
The Medical Group Management Association yesterday urged the U.S Department of Health and Human Services to take immediate action to help alleviate payment disruptions that have occurred due to the transition to HIPAA 5010.