Due to complications with timing, the Centers for Medicare and Medicaid Services (CMS) has delayed implementation of the three new episodic payment models (EPM) and Cardiac Rehabilitation (CR) incentive program until January 1, 2018.
Executives in the healthcare industry are constantly looking for more accurate ways to manage and balance their pricing strategies.
It’s no secret that healthcare prices have skyrocketed over the last 20 years.
It seems like everyone has a personal story (or knows someone) who has had sticker shock for a healthcare service.
There’s no denying that Big Data is everywhere in our day-to-day lives. By some estimates, there has been more data created in the past 2 years than in all of human existence combined.
The rapid evolution of technology is aiding the vast amount of choices we have in the consumer world to leverage machine learning in an effort to study our habits and predictively deliver what we are looking for, when and where we need it.
CMS called a timeout this week on some of their mandatory bundled payment programs.
But that doesn't mean the value-based reimbursement game has been cancelled.
With tens of thousands of line items and hundreds of carve-out clauses in fee-for-service and percentage of charge contracts, managing reimbursement terms with government and commercial payers can be a tough task if you don’t have the right tools. Just like anything else.
Rather than starting off this blog with a cliché ice breaker like “Webster’s dictionary defines denial management as…,” let’s dive right into it. What is denial management? How can it help your hospital? Does it really work? Let me tell you right now, the answer is yes. But here’s why.
In short, denial management in healthcare refers to a system where a patient’s claim for a medical service gets denied by the payer.
And the healthcare industry is no exception.
We're pleased to announce that PMMC has been selected by JFK Health, based in Edison, NJ, for bundled payment analytics to manage the costs for the Comprehensive Care for Joint Replacement (CJR) Model.
Be sure to join PMMC next Tuesday, October 18th for a webinar featuring The MetroHealth System, to learn how they are navigating price transparency requirements by offering online, self-service patient estimates.