Supporting Our Clients Against MA Plans’ 340B Inequities
Providers are being ignored by contracted and non-contracted MA plans in their efforts to obtain a remedy for 340B drug underpayments. … Read More
November 13, 2024
Insights
Ideas, insights + industry updates
3 Proactive Steps to Counteract Payer Denials and Delays
Receiving accurate, timely reimbursement and reducing unnecessary administrative cost imposed by payers requires a proactive strategy. … Read More
November 5, 2024
An Open Letter on UnitedHealthcare’s Line Item Denials Policy
UHC’s line item denials policy raises more questions than answers and significant concerns for our healthcare partners and their patients. … Read More
October 28, 2024
Recent ACA Plan Growth Holds Risks + Opportunities for Providers
Healthcare providers must advocate for the extension of ACA plan enhanced subsidies to protect tenuous financial margins. … Read More
October 1, 2024
Whistleblower Program Incentivizes Reporting of Healthcare Fraud
A new corporate whistleblower program incentivizes reporting of healthcare fraud involving private insurance plans. … Read More
September 30, 2024
Deep Dive: Is Your Practice in the Pre-Payment Review ‘Penalty Box’?
Pre-payment review means you must submit medical records with each affected claim before the payer will agree to pay or adjudicate claims. … Read More
September 6, 2024
An End-to-End RCM Partner Is Not a Traditional Vendor
An end-to-end RCM partner shapes strategy throughout the revenue cycle, while traditional vendors operate at a task level. … Read More
August 29, 2024
Tracking Recently Enacted State Laws That Impact the Revenue Cycle
Many bills have been pending in state legislatures. Let’s take a look at what’s been recently enacted in three of those states. … Read More
July 29, 2024
The Ultimate Guide to Revenue Cycle Assessments
How to determine if an RCM assessment is right for you and how to select the right partner. … Read More
July 8, 2024
Examining the Decision to Outsource
See why future-focused healthcare leaders view the revenue cycle as a value driver, not a cost center. … Read More
June 18, 2024