Articles Tagged With: Insurance
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OIG Issues Alert on Telemedicine Fraud
The Department of Health and Human Services Office of Inspector General recently issued a Special Fraud Alert on arrangements with telemedicine companies, describing seven characteristics that could suggest a risk of fraud and abuse.
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Analysis Reveals More About Claims Denials Tied to ACA Marketplace Plans
Meanwhile, evidence mounts indicating access to proper insurance coverage leads to better cancer outcomes.
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Control Factors That Influence Insurance Premiums
Insurance premiums are influenced by many factors. Some factors are out of the insured healthcare organization’s control, but hospitals can earn lower premiums by showing a concerted effort to improve patient safety and lower risk. -
Providers and Patients Alike Grapple with Spiking Prices
Patients are shelling out more money in insurance premiums as they seek ever-costlier, complex treatment more often, which providers are struggling to afford to offer.
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Surprise Bill Legislation Means Big Changes for Patients and Hospitals
“Bad news travels fast, and good news travels more slowly ... It’s a major problem, and it will take years to unwind the anxieties that have been created.”
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Revamped Tactics Needed to Overturn Surge of Denied Claims
Forced to invest significant resources trying to overturn all these denials, patient access departments are searching for the most efficient and effective way to do it.
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Waived Cost-Sharing Is Questionable Help to Hospitals
Hospitals may not charge patients with any type of insurance cost-sharing for COVID-19 testing and related services, according to the Families First Coronavirus Response Act. This will certainly help patients. For hospitals, it probably means more lost revenue.
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Some Patients Present With ‘Hidden’ Insurance Coverage; Patient Access Can Uncover It
Certain patients who say they do not have any insurance actually are covered in some way. It is the job of patient access staff to find it — and avoid uncompensated care for the hospital.
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Insurance Companies Steering Patients Away From Hospital Sites
Registrars are canceling procedures on short notice much more often these days, not because anyone needs to reschedule but because insurance companies are contacting patients to tell them the hospital setting will cost more.
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Did Patient’s Insurance Change? Auths, In-network Status May Change Too
Patients often fail to tell patient access if their coverage changes, and eligibility verification software responses do not always catch it. This article discusses steps that can help prevent claims denials.