6 Reasons for Claims Errors and How to Avoid Them
The repercussions of errors on the healthcare claims processing workflow can be major and wide-ranging. It slows the revenue cycle, interrupts cash flow, consumes staff […]
The repercussions of errors on the healthcare claims processing workflow can be major and wide-ranging. It slows the revenue cycle, interrupts cash flow, consumes staff […]
The payer policy rollercoaster has taken a few twists and turns recently, leaving healthcare organizations out of the loop if they try to keep pace […]
The Appropriate Use Criteria (AUC) program is due to come into full effect in January 2023 at the earliest. The program was established by the […]
Claims denials are a major source of headaches for healthcare organizations. On average, denied claims can take more than two weeks longer to pay out […]
In the sixth article in our series on how the patient journey has evolved since the onset of COVID-19, we look at three ways to […]
The California-based health system and insurer has bilked CMS out of “hundreds of millions of dollars” by submitting claims that were altered to make patients […]
UnitedHealthcare and United Behavioral Health agreed to the settlement to resolve allegations that they illegally denied coverage for mental health and substance use disorder treatments. […]
Consumer-led care hit its stride during the pandemic. COVID-19 unlocked healthcare’s digital front door, giving patients more control over how and when they schedule and […]
GS Labs, a Covid-19 testing provider, has submitted over $9.2 million in claims to the insurer as a result of its grossly inflated prices, the […]
Per a policy update that went in to effect July 1, the health insurance giant is not covering non-emergency services that members receive at out-of-network […]
UnitedHealthcare is instituting a new policy beginning July 1 that changes how the payer assesses emergency department claims, allowing it to retroactively deny ones it […]
Product featured in this article: Coverage Discovery As of the end of March 2021, more than 53 million Americans have been fully vaccinated, allowing for […]
Many thought the end of COVID-19 was in sight with the availability of a vaccine, and while that is somewhat true, an entirely new set […]
In a lawsuit filed three years ago, Aetna alleged that Mednax had overbilled for medical procedures and services. Now, the insurer is accusing the medical […]
It is estimated that 30-50% of denied claims occur on the front end during the patient access process, namely during registration, authorization and eligibility. Unfortunately, […]
There is no question that providers’ bottom line has been hit hard this year, and a new surge in COVID-19 is bound to threaten hospital […]
Claims denials put a big dent into the budgets of healthcare providers – something many organizations can’t afford today given the current pandemic. In an […]
In a trial last year, a federal judge found that a UnitedHealth subsidiary had illegally denied mental health and substance use disorder claims. The same […]
With COVID-19 leading to postponed and cancelled medical appointments, more consumers are turning to “contactless care”. Recent figures suggest telehealth adoption has shot up from […]
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