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Hospital monopolies ruin MRI bill as Sutter gets price it wants
After Mark Logsdon tore a ligament in his knee skiing at Lake Tahoe in March, he returned home to suburban Sacramento...
RAC Provisions Putting CMS, Providers at Odds
In response to feedback from the RACs, providers, suppliers, and their associations, CMS recently expanded its fiscal...
New Issues Highlight Need for RAC Strategy
Last December, the first sets of complex RAC review issues were released. Since then, the list has grown, as each RAC...
Four Ways to Untangle RAC's Medically Unlikely Edits
Connolly Healthcare and CGI recently added Medically Unlikely Edits for outpatient hospital claims to its CMS-approved...
Denials Bleed You: Four Ideas to Fix It
Claims denials are a daily occurrence, and are all the more frustrating when it means your hospital is bleeding...
RAC Begins Complex DRG Validation Audits
Connolly Healthcare has announced the first issues approved for complex RAC review, so providers in several RAC Region...
House Passes Red Flag Exemption for Small Practices
The House of Representatives unanimously passed a bill Tuesday, October 22, that would exempt a healthcare practice...
Hospitals Still Not Over the Hump
Despite the positive news from a Thomson Reuters study last week, which found that hospital margins had rebounded in...
Lessons Learned: How Scripps Health keeps making $100 million
For a third year in a row, San Diego-based Scripps Health has surpassed the $100 million marker in operating income...
CMS Updates RAC Audit Timeline: Complex Reviews Still Months Away
CMS anticipates Recovery Audit Contractor automated reviews will begin in late June and July and certain types of...
The Healthcare Executive's Guide to Urgent Care Centers and Freestanding EDs
One in five Americans lacks adequate access to primary care physicians and even those patients with insurance and a...
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