The American Medical Association called the Biden Administration’s interim final rule on surprise billing an undeserved gift to the insurance industry that will reduce health care options for patients.
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By David W. Johnson – In the classic “Casablanca,” cynical restaurateur Rick Blaine operates Rick’s Café Américain in occupied French Morocco during WWII. In an iconic scene, Louis tells Rick that he’s closing his establishment because he’s “shocked, shocked to learn there’s gambling in the cafe” just as a casino worker hands Louis his winnings.
By Bernard J. Wolfson – A federal price transparency rule that took effect this year was supposed to give patients, employers and insurers a clearer picture of the true cost of hospital care.
By Pamela J. Gallagher – Hospitals and health systems have spent the past decade responding to patient and government demands for increased price transparency, and the demand only continues. While the healthcare industry has made strides in ensuring patients know the cost of their care up-front…
By David Shelton – A staggering 90% of physicians say manual prior authorizations are a concern, according to the 2019 CAQH Index. Further magnifying the current situation are payers’ intentions to increase prior authorization requirements for even more services in the near future.
By Deirdre Ruttle – The idea of a largely digital world is no longer a far off fantasy. It is today’s reality. Digital adoption is expected to continue growing as precautionary guidelines related to COVID-19 encourage limited in-person interactions whenever possible.
By David Shelton – The effects of COVID-19 on global health, economies and societies have been well documented and are nothing short of staggering. Millions of Americans face uncertain financial futures, which in turn creates uncertainty for organizations to whom consumers owe money.
By Kaitlyn Houseman – When a patient’s insurance claim is denied, not only can your cash flow be affected, the relationship with your patient can be damaged as well. Some claim denials can be successfully appealed, but even when appeals succeed, they can…
(CMS took action to cover FDA approved or cleared laboratory diagnostic tests using Next Generation Sequencing (NGS) for patients with germline (inherited) ovarian or breast cancer.