🌐 The U.S. healthcare system is evolving, and the CMS Interoperability and Prior Authorization Final Rule is at the forefront of this transformation. In our latest insight, we dive into the challenges and opportunities this rule presents for payers, from API implementation to enhanced data sharing and streamlined prior authorizations. Read the full article and stay ahead of the curve! 📖 https://hubs.ly/Q02Y7Nh30 #HealthcareInnovation #PatientCare #AArete
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CMS' Interoperability and Prior Auth rule will require health plans to transform prior auth processes and invest in technology. Plans need to begin this change to ensure they are in compliance by 2027. #CMSInteroperability #priorauthorization #healthplan
🌐 The U.S. healthcare system is evolving, and the CMS Interoperability and Prior Authorization Final Rule is at the forefront of this transformation. In our latest insight, we dive into the challenges and opportunities this rule presents for payers, from API implementation to enhanced data sharing and streamlined prior authorizations. Read the full article and stay ahead of the curve! 📖 https://hubs.ly/Q02Y7Nh30 #HealthcareInnovation #PatientCare #AArete
The CMS Interoperability and Prior Authorization Final Rule: Challenges, Opportunities, and Strategic Considerations for Healthcare Payers - AArete
https://www.aarete.com
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Consumers may be caught unawares when they learn about new healthcare rules (and benefits) that will impact their enrollment decisions. Is your contact center team ready? Learn how payers and PDMs can prepare for a wave of new questions 👉 https://lnkd.in/gykKKJMm #IRA #CMS #RealSkill #MOOP #MPP #OEP #MedicarePartD
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Struggling to better understand how pricing transparency data can be used in your practice? Let SumHealths comprehensive expertise and atlas of both hospital pricing transparency, and newly introduced payer data, provide a new means to serve your patients in this new era of pricing transparency. In today's healthcare landscape, transparency is not just a regulatory requirement but a cornerstone of patient trust and practice efficiency. At SumHealth, we provide comprehensive pricing transparency data, empowering practitioners to enhance their practice's transparency and develop detailed, itemized billing structures. Transparency in healthcare pricing is pivotal for building patient trust and ensuring compliance with industry standards. By leveraging SumHealth's extensive data, practitioners can gain insights into their service charges relative to other hospitals and practices. Our pricing transparency data offering is done within the following terms: (1) Comparative analysis platform which enables you to align your pricing strategies with market standards, fostering a transparent environment that patients appreciate. We share this comparative analysis through the SumHealth platform by giving you the ability to generate your own reports, OR our team at SumHealth can work together with you to create specific insights based on the services and prices that you would like to compare and contrast. (2) A web-based application for you and your patients to use at the point of care. Interactively search through all the prices available for services that you are prescribing for your patients to present prices that they can expect when receiving care at a practice different from yours. Patients are more likely to trust and remain loyal to practices that are upfront about their pricing. Transparent, itemized bills demystify healthcare costs, enabling patients to see exactly what they are paying for. This clarity can lead to higher patient satisfaction, positive reviews, and increased referrals, ultimately contributing to the growth of your practice. In a competitive healthcare market, practices that offer transparency stand out. Using SumHealth's data to develop transparent billing practices, you position your practice as a leader in ethical and patient-centered care. This distinction can attract more patients who value honesty and clarity in their healthcare providers. Embracing transparency through detailed, itemized billing aligns your practice with regulatory standards, builds trust, and enhances operational efficiency. SumHealth is committed to providing the data and support you need to implement these practices seamlessly. Join us in transforming healthcare transparency for the betterment of your training and the satisfaction of your patients. #pricingtransparency #healthcare #primarycare #medicare #medicaid
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🚨 YouCompli White Paper 🚨 The healthcare revenue cycle is the lifeblood of many medical practices or healthcare facilities, directly impacting financial health and sustainability. It’s also the gateway to various other reimbursement opportunities such as bonuses, utilization, and other administrative resources. However, with the increasing complexity of healthcare, regulations, patient expectations, and stricter payer contracts, four specific areas within the revenue cycle have become critical focus points or “hot spots.” These require more review and internal scrutiny for regulatory compliance, and can lead to significant challenges if not adequately addressed. This paper outlines the four main hot spots of the healthcare revenue cycle and discusses strategies to optimize reimbursement. It also underscores the potential for significant improvement in these areas. Download the white paper here ➡️➡️➡️ https://hubs.la/Q02RcqJj0 #compliance #healthcare #RevCycle #CMS #OIG
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Our latest Insight post explores how teamwork across departments and innovative technologies can streamline compliance efforts. Discover more in our latest post, "Innovative Approaches to Compliance Reviews: A Playbook for Healthcare Payers." Read the full post now: https://lnkd.in/eS5r-mna #HealthcareCompliance #ComplianceReviews #BHMHealthcareSolutions
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Struggling to better understand how pricing transparency data can be used in your practice? Let SumHealth's comprehensive expertise and atlas of both hospital pricing transparency, and newly introduced payer data, provide a new means to serve your patients in this new era of pricing transparency. In today's healthcare landscape, transparency is not just a regulatory requirement but a cornerstone of patient trust and practice efficiency. At SumHealth, we provide comprehensive pricing transparency data, empowering practitioners to enhance their practice's transparency and develop detailed, itemized billing structures. Transparency in healthcare pricing is pivotal for building patient trust and ensuring compliance with industry standards. By leveraging SumHealth's extensive data, practitioners can gain insights into their service charges relative to other hospitals and practices. Our pricing transparency data offering is done within the following terms: (1) Comparative analysis platform which enables you to align your pricing strategies with market standards, fostering a transparent environment that patients appreciate. We share this comparative analysis through the SumHealth platform by giving you the ability to generate your own reports, OR our team at SumHealth can work together with you to create specific insights based on the services and prices that you would like to compare and contrast. (2) A web-based application for you and your patients to use at the point of care. Interactively search through all the prices available for services that you are prescribing for your patients to present prices that they can expect when receiving care at a practice different from yours. Patients are more likely to trust and remain loyal to practices that are upfront about their pricing. Transparent, itemized bills demystify healthcare costs, enabling patients to see exactly what they are paying for. This clarity can lead to higher patient satisfaction, positive reviews, and increased referrals, ultimately contributing to the growth of your practice. In a competitive healthcare market, practices that offer transparency stand out. By utilizing SumHealth's data to develop transparent billing practices, you position your practice as a leader in ethical and patient-centered care. This distinction can attract more patients who value honesty and clarity in their healthcare providers. Embracing transparency through detailed, itemized billing not only aligns your practice with regulatory standards but also builds trust and enhances operational efficiency. SumHealth is committed to providing the data and support you need to implement these practices seamlessly. Join us in transforming healthcare transparency for the betterment of your practice and the satisfaction of your patients. #pricingtransparency #CMS #medicare #medicaid #primarycare #healthcare
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Check out my latest article on RCM!! I talk about the four spots in the revenue cycle! We know about RCM but can we cite regulatory issues when needed. I invite you to take a look and see how this pertains to your organization. Allow Turner Expert Consulting Services LLC help you through all of the questions you may have regarding the integrity payment within the entire revenue cycle process!! Download your copy today!!
🚨 YouCompli White Paper 🚨 The healthcare revenue cycle is the lifeblood of many medical practices or healthcare facilities, directly impacting financial health and sustainability. It’s also the gateway to various other reimbursement opportunities such as bonuses, utilization, and other administrative resources. However, with the increasing complexity of healthcare, regulations, patient expectations, and stricter payer contracts, four specific areas within the revenue cycle have become critical focus points or “hot spots.” These require more review and internal scrutiny for regulatory compliance, and can lead to significant challenges if not adequately addressed. This paper outlines the four main hot spots of the healthcare revenue cycle and discusses strategies to optimize reimbursement. It also underscores the potential for significant improvement in these areas. Download the white paper here ➡️➡️➡️ https://hubs.la/Q02RcqJj0 #compliance #healthcare #RevCycle #CMS #OIG
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Stay informed with the latest in healthcare technology! Veradigm®'s 2024 EHR Regulatory Updates are here to keep you ahead of the curve. Learn about the newest changes in EHRs, how they impact your practice, and what you can do to stay compliant. Don’t miss out on this essential information for a more efficient and effective healthcare experience. https://buff.ly/3VZwZGP #HealthcareTech #EHRUpdates #Veradigm
Top Insights from 2024 EHR Regulatory Requirement Updates | Veradigm
veradigm.com
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Prior authorization has long been a significant pain point for healthcare providers and patients. Discover how CMS's Final Rule intends to simplify the revenue cycle, and find out how maxRTE's Prior Authorization solution can help providers gain the advantages of this Rule before it becomes mandatory in 2026. #priorauthorization #rcm https://lnkd.in/eTMhfb8h
CMS's Prior Authorization Final Rule to Streamline Your Revenue Cycle - maxRTE
https://maxrte.com
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Observations from the Field: Understanding and Leveraging CMS-0057 for Strategic Advantage. The CMS-0057 rule brings forward a series of critical requirements designed to enhance interoperability and streamline prior authorization processes. These mandates are intended to improve data exchange between payers, providers, and patients, but they also pose challenges as payers adapt their systems and workflows to meet compliance. Point-of-Care Partners clarifies these challenges and corrects any misconceptions that might hinder payers from maximizing the strategic benefits of CMS-0057. https://lnkd.in/eFfrNxFK?
Observations from the Field: Understanding and Leveraging CMS-0057 for Strategic Advantage
blog.pocp.com
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