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CMS  |  Price Transparency

Pricing Transparency Evolves: Ensuring Hospital Compliance Amidst New Regulations

By: Greg Kay August 1st, 2023

In July 2023, CMS proposed some major price transparency changes with the release of the 2024 OPPS rules. Most notably, the proposed rule changes move to standardize the formatting of the machine-readable files (MRF), increase data accessibility and greater accountability. This can lead to a significant impact on hospitals that are not completely compliant with existing regulations. Even if you believe your organization is 100% compliant today, the proposed changes may expose your hospital to penalties. Let’s examine the proposed price transparency changes and highlight how PMMC is quickly moving to incorporate these changes to help our clients remain compliant.

Price Transparency

Pricing Transparency Laws and the Need for Reliable Estimator Software

By: Joseph Cherian July 12th, 2023

The CMS’ hospital price transparency laws are in full effect. In addition to requiring hospitals to post pricing data online, these regulations also make it mandatory for facilities to provide estimates to patients upon request and include estimates for ancillary providers as well.

contract modeling

Ensuring Payer Contracts Are Being Maximized with Contract Modeling

By: Debbie Marks June 22nd, 2023

Contract modeling software can help healthcare decision-makers look beyond their revenue cycles and adapt to industry trends to maximize profitability. Partnering with an experienced contract modeling system provider like PMMC is also helpful for evaluating payer contracts and ensuring that they’re being fully maximized. Let’s further examine contract modeling software, including why hospitals need them and the benefits they provide.

contract modeling

Modeling Payer Proposals to Maximize Return and Cash Flow

By: Matt Goss April 25th, 2023

Over the last several years, hospitals and healthcare groups have been ravaged by pandemic-related revenue losses. According to the American Hospital Association, in 2021 alone, U.S. hospitals lost approximately $54B in net income. Despite that, hospital leaders strive to achieve an economic resurgence by reducing operating expenses, streamlining operations, and perhaps most importantly, restructuring payer proposals to maximize their returns.

Recovery

Overcome Staffing Challenges with Recovery Services

By: Jena Seymore April 4th, 2023

Most hospitals have been feeling the effects of ongoing staffing challenges. Hospitals across the nation are struggling to hire and retain both frontline care providers and administrative talent like accounting personnel.

Patient Estimates

Counting the Costs of Inaccurate Patient Estimates

By: Chad Shields March 15th, 2023

Since early 2020, hospitals have been contending with unprecedented challenges that have negatively impacted their revenue and profitability. Throughout 2022, 53% of hospitals had negative margins, according to the American Hospital Association, and even those projected to end the year with positive margins are still recouping from the financial hurdles of the last few years.

Recovery  |  revenue cycle contract management

Modernizing Revenue Recovery Through the Power of AI

By: Brian Kenyon February 20th, 2023

A revolutionary new AI tool is poised to change how healthcare organizations manage revenue recovery and protect cash flow.

PMMC Recognizes April Miller from Pennsylvania Mountains Healthcare Alliance (PMHA)

By: PMMC Staff September 19th, 2022

We would like to congratulate April Miller, Director of Contracting and Payor Relations at PMHA, as PMMC's Star of the Month!

PMMC Recognizes Sheila Morris from Shepherd Center as Star of the Month

By: PMMC Staff August 23rd, 2022

We would like to congratulate Sheila Morris, Revenue Cycle Director at Shepherd Center as PMMC's Star of the Month!