New & Notable
90% of medical coding staff worry about upcoding, fraud
Healthcare fraud, such as upcoding and unbundling, has medical coding and billing professionals worried about the industry.
How healthcare leaders can mitigate concentration risk
Healthcare organizations are especially susceptible to concentration risk, creating a single point of failure that can jeopardize operations, Forrester researchers suggested.
CFPB warns medical debt collectors of consumer rights laws
Medical debt collectors may not attempt to collect on debts that are inaccurate or inflated, according to the CFPB.
Healthcare M&A revenue reaches $13.3 billion in Q3 2024
Healthcare M&A surged in Q3 2024, driven by portfolio realignments and health system expansion into new markets, according to Kaufman Hall.
Insights
Insights is the research division of Xtelligent Healthcare Media. Our work aims to leverage Xtelligent’s diverse readership of healthcare professionals across various sectors of the industry to understand real-world challenges and identify effective solutions.
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Financial Responsibility
CareCredit
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Specialty Drug Management
Optum Specialty Fusion
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Revenue Cycle Management
Brault
Brault is a revenue cycle and practice management organization that partners with hospitals and independent physician groups. Their intelligent practice solutions include coding and billing, MIPS optimization, provider documentation training, and practice management.
Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
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Latest News
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GAO: CMS failed to ensure price transparency data accuracy
CMS said it does not have the resources or bandwidth to manually monitor accuracy and completeness of hospital price transparency data.
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Hospital consolidation shrinks metro inpatient care market
Just one or two health systems controlled the entire inpatient hospital care market in nearly half of metropolitan areas in 2022, highlighting hospital consolidation trends.
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Inflation Reduction Act cuts costs of 54 prescription drugs
Medicare Part B enrollees will see lower prescription drug costs due to a rebate program under the Inflation Reduction Act.
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Three-quarters of providers say claim denials increasing
The growing rate of claim denials poses a threat to healthcare revenue cycle management.
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CMS rule targets suspect billing in Shared Savings Program
A new CMS rule is addressing "significant, anomalous, and highly suspect" billing activity within the Medicare Shared Savings Program to mitigate financial impacts for ACOs.
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Do hospital mergers and acquisitions drive physician burnout?
Half of physicians said hospital mergers and acquisitions affect their job satisfaction, contributing to medicine's physician burnout woes.
Features
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Exploring the role of medical claim clearinghouses
Medical claim clearinghouses manage claim submissions for providers, increasing efficiency, reducing costs and improving payment accuracy.
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Unpacking the mid-revenue cycle, strategies for success
The mid-revenue cycle includes coding, CDI, and compliance, making its processes vital to a provider organization’s success.
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How Robotic Process Automation Optimizes Revenue Cycle Management
Robotic process automation (RPA) saves practices money and time by automating manual, repetitive tasks within revenue cycle management.
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Breaking Down the Back-End Revenue Cycle, Key Best Practices
When a patient encounter ends, the back end of the revenue cycle gets busy creating claims and managing A/R to optimize revenue collection and integrity.