Tag:
Denials
Latest Headlines
Latest Headlines
Pain diagnoses may be red flag for RACs
Revenue audit contractors are zooming in on hospital charges to treat both back and chest pain as the most likely sources of rejecting claims, according to a presenter at the Healthcare Financial
Medical necessity contentions are fueling more RAC denials
Hospitals reported $167 million worth of claims denied by Medicare Recovery Audit Contractors between the first quarter of 2010 and the first quarter of this year, although in many instances the
AHA wants more clarity on hospital-acquired penalties
The American Hospital Association is seeking more clarity regarding guidelines for payment denials related to conditions acquired in a healthcare setting, reports AHA News. Although the Centers for
Insurers often reverse claims denial, GAO says
A new report from the Government Accountability Office found that although insurers frequently deny claims due to billing errors, missing information or judgments on whether the care or service is
Many RAC denials overturned on appeal
The recovery audit contractors working on behalf of the Medicare program denied a total of $86 million in claims during 2010--many of which were overturned on appeal--according to a survey of 1,850
Insurers distrust data provided on new HHS website
AHIP is questioning the denial rates that appear on a new HHS website when consumers search for insurance in their zip code. Healthcare.gov , the website HHS created to be a one-stop consumer
AHA: RAC activity, audits up
Medicare's recovery audit contractors are keeping up pressure on claims denials, according to a new survey by the American Hospital Associations. AHA's voluntary RACTrac survey on Medicare recovery
SPOTLIGHT: NY Consumers won 47 percent of appeals in 2009
Consumers seeking to reverse health plans' denials of coverage won 33,921 internal appeals against commercial insurers in 2009 out of 71,787 cases closed, according to the Consumer Guide to Health
A bad time to hold back Medicare payments
As Modern Healthcare reports this week, more than 60 hospitals could lose almost $5 million collectively this year. Are we talking about problems with collecting patient debts? Poor payer mixes?
AMA issues first health insurer report card
Increasingly, providers and their vendors have begun to rate insurance companies. This comes in part as a means of turning the tables on the insurers who, some say, have become far too focused on
