Medicare Advantage (MA) plans and Accountable Care Organizations (ACOs) should be reevaluating their vendor strategy in light of coming changes.
This is largely because of a new version of the Hierarchical Condition Category (CMS-HCC) risk adjustment model that CMS released in 2023. It includes changes that will enhance the value of partnering with an experienced vendor for in-depth retrospective and concurrent risk adjustment reviews. Leaders at these organizations will benefit from
Medical providers should be doing everything they can to get in front of the medical billing changes that are coming next year – and this starts with understanding what’s in the forecast
Finding new opportunities for pediatric billing is critical to maintaining the health of pediatric medical practices, and new legislation might be a change that aligns with the health of the children and families you care for. As you review the act, look for
“As goes Texas, so goes the nation”. This saying is something anyone responsible for physician billing services should keep in mind when considering the impact of the Texas Medical Billing law. While the bill targets “healthcare facilities”, providers at all levels should pay attention – this type of legislation signals a shift in demands around the patient experience,
Revenue cycle management has grown to an unmatched level of complexity in recent years. For most organizations, this has meant increased needs for training and improved hiring processes – but is it possible there’s a limit to the effectiveness of these tactics?
If you take a close look at the requirements of many revenue cycle roles, you’ll likely find something interesting. A select few are so complex, that they require looking outside the organization for expertise to access a higher level of performance in revenue cycle management services. These are typically positions that have
