CMS Tightens Prior Authorization Time Frame in Final Rule
Health plans will be required to meet a prior authorization time frame as short as 72 hours, along with providing reasoning for any denials. … Read More
January 30, 2024
Insights
Ideas, insights + industry updates
Opt for Outcomes with End-to-End RCM Vendor Selection
When it comes to selecting the right revenue cycle management (RCM) partner, there are crucial factors beyond cost considerations. … Read More
January 24, 2024
Ensemble’s AI Impact
See how Ensemble is actually applying AI to drive value across the entire revenue cycle. … Read More
January 16, 2024
Revenue Cycle Managed Services Fill In-House Gaps
By partnering externally for RCM support, organizations gain efficiency, increase agility and are better able to use limited resources. … Read More
January 10, 2024
OIG Increases Scrutiny on Medicare Advantage Coding
Federal agencies are scrutinizing Medicare Advantage coding with inaccurate diagnoses for enrollees with certain high-risk diagnoses. … Read More
October 27, 2023
How to Prevent Burnout During an Electronic Healthcare Record Implementation
There’s no need to go into an EHR implementation unprepared. Having a readiness program in place can help smooth the transition to a new EHR. … Read More
October 27, 2023
Clarification of the Two-Midnight Rule: A Win for Physician Advisory
The 2024 Medicare Advantage Final Rule clarifies that Medicare Advantage (MA) plans must follow the Two-Midnight Rule set in 2013, and more. … Read More
October 25, 2023
Congress Investigates OIG Report That Medicaid MCOs Deny Prior Authorizations at Higher Rates
A report from the OIG found some MCOs have unusually high rates of prior authorization denials, with limited or no state oversight. … Read More
October 3, 2023
5 Key Focus Areas for Healthcare’s Future
In a rapidly shifting industry, here are five areas of focus to help you face healthcare’s future with confidence. … Read More
October 3, 2023
Providers Should Push Back Against Direct EMR Access for Payers
Lessons learned from providers who have granted direct EMR access to payers. … Read More
August 29, 2023