Industry News

Stay on top of the business of healthcare. Check this page often for published articles, trends and revenue cycle research studies.

CMS Clarifies Healthcare Price Transparency Rules for Hospitals

By RevCycle Intelligence | October 16, 2018

CMS recently expanded on new healthcare price transparency requirements for hospitals in a series of frequently asked questions (FAQs) published on its website. The FAQs cover which hospitals are subject to the new requirements, the definition of machine-readable, and what items and services furnished at the hospital must be included on the publicized list.

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Maximizing Revenue Through Clinical Documentation Improvement

By RevCycle Intelligence | September 28, 2018

Clinical documentation improvement (CDI) is the process of enhancing medical data collection to maximize claims reimbursement revenue and improve care quality. In addition to its impact on patient care, the quality of data generated within the electronic health record and elsewhere in the organization is increasingly tied to cost efficiency under value-based reimbursement models.

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AMA releases 335 coding changes for 2019

By Becker's Hospital Review | September 19, 2018

The American Medical Association has released the 2019 Current Procedural Terminology code set. The code set was released Aug. 31, and the AMA announced the release Sept. 5

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AMA Adds Connected Health CPT Codes, Pushes for Medicare Payment

By RevCycle Intelligence | September 10, 2018

The American Medical Association (AMA) updated the Current Procedural Terminology (CPT) code set in 2019 to include new codes for connected health services in an effort to encourage CMS to pay for the services. The 2019 CPT code set contains 335 code changes that will go into effect for medical billing and coding on Jan. 1, 2019.

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8 most common medical coding errors

By Becker's Hospital CFO Report | August 15, 2018

Government and private health insurer audits have recently revealed several fraudulent or abusive medical billing practices, Kevin B. O’Reilly, editor of AMA Wire, said. Providers need to ensure proper billing practices not only to avoid fraud, but to maintain a profitable business.

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Exploring the Fundamentals of Medical Billing and Coding

By RevCycle Intelligence | August 6, 2018

Medical billing and coding translate a patient encounter into the languages used for claims submission and reimbursement. Billing and coding are separate processes, but both are crucial to receiving payment for healthcare services.

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How Hospital Merger and Acquisition Activity is Changing Healthcare

By RevCycle Intelligence | July 23, 2018

As value-based reimbursement puts financial pressure on providers, healthcare organizations are striving for efficiency, cost control, and sustainability. An increasingly popular strategy to fulfill all these goals is to engage in hospital merger and acquisition (M&A) activity.

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How to Maximize Revenue with Improved Claims Denials Management

By RevCycle Intelligence | July 21, 2018

Claims denials may be a part of life for healthcare revenue cycle managers, but a prevention-focused denials management strategy may be able to significantly reduce the number of times billing staff are faced with unpaid claims.

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CMS Proposes 2019 Physician Payment, Quality Payment Program Changes

By RevCycle Intelligence | July 18, 2018

CMS recently proposed major changes to Medicare physician payments and the Quality Payment Program to reduce the administrative burden of medical billing.

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Overcoming the Top Challenges of Claims Denial Management Audits

By RevCycle Intelligence | July 17, 2018

Increasing efficiency and improving revenue are top priorities for health care providers with a big focus on improving prior authorizations and eligibility before an episode of care. However, leveraging data and consulting expertise to improve denials management can be something that most providers often overlook.

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Key Terms, Components of Payer Contracts Providers Should Know

By RevCycle Intelligence | July 16, 2018

Providers are in the business of keeping their patients healthy. But confusing payer contracts riddled with “legalese” and other complicated provisions can get in the way of improving patient outcomes.

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What Is Healthcare Revenue Cycle Management?

By RevCycle Intelligence | July 9, 2018

While hospitals, small practices, and larger healthcare systems are known for saving lives and treating patients, every healthcare organization needs to develop successful processes and policies for staying financially healthy. That is where healthcare revenue cycle management comes in.

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How to Maximize Revenue with Improved Claims Denials Management

By RevCycle Intelligence | July 9, 2018

Claims denials may be a part of life for healthcare revenue cycle managers, but a prevention-focused denials management strategy may be able to significantly reduce the number of times billing staff are faced with unpaid claims.

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What Are the Benefits of Clinical Documentation Improvement (CDI)?

By EHR Intelligence | July 2, 2018

As healthcare organizations continue to utilize data that is becoming increasingly complex, it is essential that the data is captured and documented properly. Clinical documentation improvement (CDI) helps ensure that the events of the patient encounter are captured accurately and the electronic health record properly reflects the services that were provided.

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WHO releases ICD-11: 5 things to know

By Becker's Hospital CFO Report | June 25, 2018

After more than a decade in the making, the 11th edition of the International Classification of Diseases has been released by the World Health Organization. The ICD serves as a foundation for identifying global health trends and statistics and is used by health insurers whose reimbursements depend on ICD coding.

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