Revenue Cycle News Update – July 1, 2019
This regular feature showcases the most vital recent news stories in healthcare IT and revenue cycle management.
Here are the top stories since our last news roundup, as well as what you’ll need to know in the next few weeks.
Medicare / Medicaid News
The settlement ends a two-year dispute with the inpatient rehabilitation industry after they were frequently denied Medicare claims for a variety of reasons, including if the patient missed a few minutes of their minimum time of daily therapy. Medicare would only pay for the therapy if beneficiaries participated at least three hours a day.
In an effort to reduce provider burden and improve patient access to medication, CMS has issued a proposed rule to update e-prescribing standards, the agency announced June 17.
Private Payer News
Only 20 percent of the nearly 1,600 hospital and health system CFOs, VPs of finance and revenue cycle management, and other senior finance leaders surveyed said more than a quarter of their organization’s financial and revenue cycle operations were fully digitized or automated.
One solution is to incorporate a system that offers instantaneous eligibility verification at the point of registration to eliminate manual processes.
The report, which leveraged Medical Expenditure Panel Survey (MEPS) data from between 2011 and 2016, revealed that 25 percent of the nearly 17 million cancer survivors in the US face high material costs for their care. Material costs include the financial costs of a condition, such as paying medical bills or borrowing money from other sources to pay those bills.
“In many of these cases, the patient not only is at risk of being balanced-billed by the provider, but also likely faces higher out-of-pocket costs under her insurance plan for the out-of-network claims,” the study finds.
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