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CMS Price Transparency Final Rule - Hospitals Must Publish Charges in 2019

What is the CMS Price Transparency Final Rule? In an effort to increase price transparency for consumers, CMS has updated its guidelines under the Final Rule CMS-1694-F (which is part of FY 2019 IPPS/LTCH PPS) that requires hospitals to post standard charges online in a machine readable format. This will be required for all hospitals beginning January 1, 2019.

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Top 3 Trends in Denial Management

During our recent webinar session “Denial Management Essentials: The Metrics and Reporting Tools You Need to increase Revenue” we polled healthcare providers on several topics around denial management.

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How Prevalent are Narrow Networks In Healthcare Today?

During our recent webinar session “Winning Strategies for Contracting in Narrow Networks” we polled healthcare providers on several topics around narrow networks. These questions provide insight as to how well your organization is prepared to manage narrow network negotiations. How would your healthcare organization answer these questions? Here’s how the live webinar attendees responded… 1. Is your organization currently part of a narrow network?

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Almost Half of Healthcare Providers Not Confident in Payer Contract Modeling Tools

At a time where the healthcare industry is forced to adapt to new reimbursement models, providers are having a tough time adjusting to the contract negotiation process. Each reimbursement model comes with its own stipulations and understanding how to work with the payer to reach your organization’s financial goals comes with its own set of challenges.

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The 4 Components of Payer Negotiations

Laying the Foundation

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How to Negotiate with Payers – Tips from a Managed Care Expert

Every profession has its set of experts. In the health industry’s managed care field, one of those experts is Susan Mego.

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Revenue, Cost, Productivity and Quality: The Four Modern Day Healthcare Directives Heard in Today’s Boardroom

All across the modern day healthcare landscape in hospital and healthcare system boardrooms, the four main topics discussed on a regular basis by executive leadership are focused on these business issues:

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Revenue Cycle Consolidation Causes Heartburn For Hospitals

For hospitals contemplating revenue cycle solutions, it’s important to make sure your revenue cycle solutions aren’t half-baked. Have you ever bought a bunch of ingredients and gadgets to duplicate what the pros make on a cooking show? They make it look easy…but it’s not. There are nuanced skills with timing, technique, temperature, and other subtle variables related to sequence and presentation. Cooking shows are similar to industry consolidation; be it energy, automotive, or even healthcare. So, what do we get with consolidation?

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What We Learned (Part 2): 8 Points on Narrow Networking That Every Hospital Needs to be Aware Of

This webinar has taught us a lot about a program in the healthcare industry commonly referred to as narrow networks. We learned about the pros and cons for adopting this type of system, the growing trend of employers offering this to their employees, and most importantly, the value of knowing the contracted terms before entering into these agreements. So, with that being said, what’s the biggest piece of advice we can take away from this presentation?:

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What We Learned (Part 1): How Narrow Networks Impact Healthcare Providers

During our recent webinar session “Intro to Narrow Networks: What’s the Impact on Healthcare Providers?” we polled healthcare providers on several topics around narrow networks.

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