Resources
Healthcare revenue articles, industry news & events, associations and many more
- Industry News
Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones.
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- Industry News
Some patients would be able to file an appeal of their patient status while still in the hospital, and past stays going back 15 years also could be subject to review. (more…)
- Articles, Industry News
Healthcare policymakers and stakeholders continue to mull the need for guardrails to ensure optimal customer service among Medicare Advantage (MA) health plans.
- Articles, Industry News
A majority of U.S. states are considering legislation to rightsize the time-wasting, care-delaying payer practice of prior authorization. In all, nearly 90 prior-authorization reform bills have been considered this legislative session in 30 states, and more than a dozen are still on the table for potential passage.
- Articles, Industry News
Arguably the biggest change to outpatient coverage next year will be the introduction of a new tier of behavioral healthcare services.
- Articles, Industry News
As Medicare Advantage plans rely increasingly upon artificial intelligence to determine—and often deny—payment for patient care, a group of Democratic U.S. lawmakers on Friday urged Medicare’s top official to strengthen oversight of AI and algorithmic tools used to make coverage determinations. (more…)
- Articles
The financial implications of ensuring appropriate patient status throughout a hospital stay are substantial, so it is in organizations’ interest to enhance the process. (more…)
- Industry Events
Event Date: 06/01/2023
Event Page
Keystone, Philadelphia, Three Rivers, and New Jersey AAHAM will be hosting the PA/NJ Annual Institute on June 1st with a Golf Outing on May 31st. (more…)
