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With the announcement of the nursing home minimum staffing rule, I asked myself the same question as operators nationwide: how on earth are we going to pay for this? Even if nursing homes could find ...

Workforce shortages, regulatory complexities and economic challenges have put hospitals and health systems under immense pressure to improve operational efficiency, accelerate payments and reduce ...

On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Medicaid and Children’s Health Insurance Program Managed Care Access, Finance and Quality Final Rule, a final rule that ...

Contract negotiations adhere to a rule that 80 percent of time should be used to prepare for the negotiation and 20 percent to negotiate. To help be more effective in achieving results when you ...

Coding of physician office visits can be very confusing – and is ever-changing. Every year, regulations and guidelines change, and it is difficult for providers to keep up. Most groups have coding ...

Here are seven best practices from managed care contracting experts to help you get paid fairly by third-party payors. 1. Give yourself ample time to negotiate a contract. To convince a payor that you ...

Congress should enact legislation to require the Centers for Medicare and Medicaid Services to evaluate transitioning to a single modern procedure coding system to eliminate excess costs and lower ...

On April 22, the HHS Centers for Medicare and Medicaid Services (CMS) published a long-awaited final rule regulating the use of managed care in Medicaid and CHIP. The official Federal Register version ...

The American Medical Association is overhauling how U.S. doctors report and bill for pregnancy services, bulldozing the current system of bundled payments and replacing it with more granular, itemized ...