Forbes Healthcare

JULY 1, 2025

Follow Author Jul 01, 2025, 12:26pm EDT Jul 01, 2025, 02:40pm EDT Share Save Comment WOODLAWN, MARYLAND: An aerial view of the Centers More for Medicare & Medicaid Services building on March 19, 2025. Forbes contributors publish independent expert analyses and insights. It is to deliver value for patients and taxpayers.

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Insurance Follow-Up Transfers Billing 155

Forbes Healthcare

JUNE 14, 2025

Jain Follow Author Share Save Comment Innovation Healthcare Time For Medicare Advantage Leaders—Including Me—To Eat Our Own Cooking By Sachin H. Follow Author Jun 14, 2025, 04:29pm EDT Share Save Comment Dr. Why It Matters—for Me, and for the Industry I don’t make this proposal lightly—because it would apply to me, too.

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Insurance Customer Service Follow-Up Transfers 206

Medical Economics

JULY 10, 2025

SHOW MORE The number of primary care physicians employed by health insurance payers grew from 2016 to 2023, researchers say. CEO Andrew Witty holds his hand up to testify under oath before the House of Representatives' Energy & Commerce Committee Oversight & Investigations Subcommittee on May 1, 2024. They hired how many?

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Insurance Billing Hospital Medication 90

Health Populi

NOVEMBER 21, 2024

elections, Jennifer’s assertion sums up what, ex post facto , we know about what most inspired American voters at the polls in November 2024: the economy, economics, inflation, the costs of daily living… pick your noun, but it’s all about those Benjamins right now for mainstream American consumers across many demographic cuts.

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Insurance Follow-Up Huddles/Rounds Billing 62

Forbes Healthcare

JULY 2, 2025

Cohen Follow Author Share Save Comment Innovation Healthcare To Preempt Government Action, Insurers Say They’re Fixing Prior Authorization By Joshua P. Follow Author Jul 02, 2025, 08:22am EDT Share Save Comment Insurers designate certain prescription drugs with prior authorization to ensure safe and medically. All Rights Reserved.

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Insurance Follow-Up Medication Billing 155

Healthcare Dive - Practice Management

JUNE 30, 2025

Daily Dive M-F Payer Weekly Every Wednesday IT Weekly Every Thursday By signing up to receive our newsletter, you agree to our Terms of Use and Privacy Policy. on May 5, 2023. Dive Brief: UnitedHealth is changing up the leadership of its healthcare delivery arm Optum Health, a spokesperson confirmed to Healthcare Dive Friday.

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Follow-Up Medical Coding Insurance Medication 67

Forbes Healthcare

JUNE 9, 2025

Follow Author Jun 09, 2025, 09:18am EDT Jun 09, 2025, 04:13pm EDT Share Save Comment Business district of Marquette, Michigan Gerald Bernard - stock.adobe.com In May, the U.S. House of Representatives passed a budget reconciliation bill that includes significant cuts to Medicaid.

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Insurance Follow-Up Transfers Billing 150

Healthcare Dive - Practice Management

JULY 9, 2025

Daily Dive M-F Payer Weekly Every Wednesday IT Weekly Every Thursday By signing up to receive our newsletter, you agree to our Terms of Use and Privacy Policy. In the midst of all these challenges, technologists say their innovations might hold the key to helping other manufacturers follow suit. You can unsubscribe at anytime.

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Follow-Up Medical Coding Medication Billing 105

Forbes Healthcare

JUNE 11, 2025

Follow Author Jun 11, 2025, 07:00am EDT Jun 11, 2025, 03:28pm EDT Share Save Comment Left to right Mirvie's cofounders: Maneesh Jain aand Stephen Quake Mirvie uses RNA technology to predict pregnancy complications, such as preeclampsia, through a simple blood test. Forbes contributors publish independent expert analyses and insights.

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Insurance Tests Care Plan Follow-Up 167

Forbes Healthcare

JULY 1, 2025

Follow Author Jul 01, 2025, 06:09pm EDT Jul 01, 2025, 11:04pm EDT Share Save Comment Health insurer Centene, one of the nation’s biggest providers of individual coverage under the. Forbes contributors publish independent expert analyses and insights. Bruce Japsen writes about healthcare business and policy.

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Health Populi

MAY 27, 2025

This year, we learn that outpatient care and pharmacy were the two line items most responsible for driving the PPO cost up to over $35K: pharmacy costs rose 9.7% making up 28% of spending, pharmacy (one in $5 of spending, inpatient (hospital) care constituting 17% of spending, and other line items at 2% of the remainder.

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Billing Outpatient Care Follow-Up Medication 71

Scrubs

JUNE 12, 2023

The biotech firm known as Grail made headlines earlier this year thanks to its signature Galleri blood tests, which can detect up to 50 different kinds of cancer early on to improve patient outcomes. The tests were hailed as the “first of its kind” when it hit the market in 2023. It’s that they simply didn’t exist. .

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Tests Follow-Up Billing Communication 188

Sensible Medicine

MAY 25, 2023

On April 26, 2023, Bobby Jindal and Chirag Parghi declared, on the opinion pages of the WSJ, that “ Mammograms Can Promote Heart Health.” Mammography providers would use artificial intelligence technology to quantify breast artery calcification and would add that service to the charge they currently bill. ” U.S.

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Tests Follow-Up Diagnostics Insurance 209

Health Populi

DECEMBER 1, 2023

consumers say they can’t afford to pay their medical bills on-time, based on the 2023 Consumer Survey from Access One, a financial services company focused on healthcare payments. Furthermore, one-third of consumers are not confident they could pay a medical bill of $500 or more. Two-thirds of U.S. Note that U.S.

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Billing Follow-Up Communication Insurance 71

Health Prime

MAY 2, 2024

According to The State of Mental Health in America 2023 , 28% of all adults with a mental illness reported that they were not able to receive the treatment they needed. Implement appointment reminders and follow-ups Use automated appointment reminders and follow-up communications to enhance the patient experience.

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Follow-Up Appointments Billing Scheduling 105

Health Prime

OCTOBER 10, 2024

According to The State of Mental Health in America 2023 , 21% of adults are currently experiencing a mental illness, which equates to over 50 million Americans. A 2023 IGNUX report states that hospital coding mistakes make up 63% of medical billing errors. Strategies to improve your mental health reimbursements 1.

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Billing Medical Coding Documentation Appointments 97

Health Populi

APRIL 1, 2024

Paper checks are still a go-to form of payment to patients and plan members, and there remains lots of confusion among patients when it comes to up-front pricing and eventually the EOB statements resulting from the claims payment process. This is the modus operandi for bill payment among U.S. Mailing a paper check?

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Billing Follow-Up Communication Medication 87

CollaborateMD

JANUARY 5, 2024

These days, billing can be complex. It makes billing simpler and more accurate. The medical billing market is growing fast. This growth shows just how vital medical billing is becoming. This growth shows just how vital medical billing is becoming. Medical billing software comes with many helpful features.

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Billing Medication Follow-Up Insurance 52

CareerStep

NOVEMBER 14, 2023

If you’ve ever considered a job in healthcare but don’t want to work directly with patients, medical billing and coding may be a good fit! The American Medical Association (AMA) reported that as of spring of 2023, the U.S. What do medical coders do and what do medical billing professionals do? And why are they in demand?

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Billing Medication Medical Coding Certification 52

Health Populi

JUNE 11, 2024

between 2023 and 2024, according to the 2024 Milliman Medical Index. This year, I opted for a 2025 Subaru Forester and a year’s tuition for a New Mexico resident living off-campus for 2023-24 attending University of New Mexico. Health care costs for an “average” person covered by an employer-sponsored PPO in the U.S.

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Medication Follow-Up Billing Insurance 78

The HIPAA Journal

MARCH 20, 2025

There was no letup in cyberattacks on healthcare organizations in 2023, which set two new records – The most reported data breaches and the most breached records. In 2023, 725 data breaches were reported to OCR and across those breaches, more than 133 million records were exposed or impermissibly disclosed. In 2023, 79.7%

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Business Associate HIPAA Unit Organization and Environment Hospital 110

Health Populi

JULY 24, 2023

” The quid pro quo value exchange is that GNC ramps up its membership list of consumers for the program and the promise of other purchases from the virtual or brick-and-mortar “front of the store.” consumers, found in the latest Beryl Institute-Ipsos Px Pulse survey published for July 2023.

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Insurance Acute Care Billing Follow-Up 118

Health Populi

AUGUST 21, 2023

We can see health consumers’ shifting priorities for satisfaction-boosting changing from 2019 to 2023 based on HealthEdge’s previous research. That’s followed by making access to “my” health records easier, and granting access to me to providers who align well with my preferences and personal values.

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Insurance Follow-Up Care Plan Communication 62

Relias

APRIL 27, 2023

Healthcare leaders face constant changes in regulations, billing rules, payer requirements, and technology. To keep up with all of it, your staff needs constant training. There are also qualitative benefits, like fewer billing complaints. It’s hard even for experts to keep up.

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Critical Thinking Follow-Up Billing Best Practices 52

Valant

JANUARY 25, 2024

The International Classification of Diseases, Tenth Revision (ICD-10) released updates for 2024 related to behavioral health, which went into effect October 1, 2023. The following changes will affect mental health coding: hepatolenticular degeneration (formerly E83.0, now E83.01) Parkinson’s disease (formerly G20, now G20.-)

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Billing Documentation Scheduling Communication 52

Healthcare Law Insights blog

MAY 17, 2023

1] Facelifts were up 54 percent. [2] 2] And breast procedures were up 48 percent. [3] DOJ’s Latest False Claims Act Complaint On May 9, 2023, the U.S. May 9, 2023) (government’s complaint in intervention). [7] 3] According to that study, Americans spent over $14.6 4] But, for the most part, that $14.6 1395y(a)(1)(A). [6]

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Billing Follow-Up Medication Hospital 52

Health Populi

MARCH 13, 2024

The 2023 Edelman Trust Barometer gauged U.S. adults’ levels of trust in health care services and suppliers, finding the greatest trust lies with a consumer’s local pharmacy (for 77% of consumers), followed by hospitals (for 73% of people) and in third rank, health technology (63%). The 2023 Edelman Trust Barometer gauged U.S.

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Collaboration Best Practices Triage Follow-Up 108

Relias

DECEMBER 8, 2022

The PEPPER gives your organization a snapshot of your case mix, coding, and billing practices and compares you to other providers in the nation, Medicare Administrative Contractor jurisdiction, and state. The report is available for the following facilities: Skilled nursing facilities. Why should you read the PEPPER? Average case mix.

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Acute Care Interdisciplinary Team Billing Hospice 52

Relias

OCTOBER 28, 2022

While the plan of care is always the number one area for citations, care coordination consistently ranks right up there,” said SimiTree Compliance Senior Manager Sheila Salisbury-Sizemore. At a minimum, each patient’s medical record should reflect care team coordination at the following time points: Start of care.

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Hospice Interdisciplinary Team Follow-Up Documentation 52

Minority Nurse

MARCH 22, 2023

Latanya Weston is an important nursing leader , and we’re pleased to profile her as part of the Champions of Nursing Diversity Series 2023. I was constantly stricken with various illnesses when I was growing up. Furthermore, I grew up in a community with significant health challenges, yet people didn’t prioritize their health.

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Follow-Up Care Plan Communication Hospital 98

The Healthcare Blog

APRIL 18, 2024

In November, 2023, Brynjolfsson teamed up with fellow West Coaster, Robert M. They begin their 2023 JAMA commentary this way, “History has shown that general purpose technologies often fail to deliver their promised benefits for many years (‘the productivity paradox of information technology’).

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Vital Signs Customer Service Follow-Up Medication 67

Mobius MD

AUGUST 8, 2024

This list of the top 3 EHRs follows rankings from the Best in KLAS Software and Services Report. Many organizations adopt Epic because it provides a comprehensive system for managing patient records, scheduling, billing, and clinical workflows. Finally, Epic’s prestigious reputation gives it a leg up in the industry.

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Acute Care Hospital Follow-Up Documentation 52

Healthcare Law Insights blog

MARCH 22, 2023

Senior DOJ officials have in turn emphasized in public remarks that investigating clinical research shortcomings is now a Justice Department priority, with the whistleblower bar following suit. 22, 2023), available at [link]. [2] 27, 2023) (stipulation and order of settlement). [5] Non-adherence invites DOJ scrutiny.

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Hospital Follow-Up Medication Billing 52

Minority Nurse

SEPTEMBER 10, 2024

You may have wanted to work in a particular specialty, had your sights set on the traveler lifestyle, or were focused on making sure you could pay the bills, give your kids a good life, and plan for your eventual retirement. For LPNs/LVNs , the decision to return to school can directly relate to wanting more career mobility.

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Acute Care Follow-Up Certification Billing 52

ACMA Blog

OCTOBER 16, 2023

Pharmacy Billing Specialist (PBS) : Typically, specialty pharmacies utilize a PBS to optimize the billing process through their knowledge of billing regulations and healthcare system codes. This is done following the health plan’s formulary or the criteria for a specific medication, device, or procedure being requested.

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Medical Assistant Documentation Certification Medical Coding 40

Mobius MD

JULY 1, 2024

Following their advocacy, a 2024 CMS rule requires government-regulated health plans to shorten the timeframes for prior authorization decisions. The AMA has also promoted model legislation at the state level, resulting in ten new state laws in 2023 and more than a dozen bills before state legislatures this year.

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Documentation Follow-Up Best Practices Patient Care 52

Health Prime

JANUARY 24, 2024

between 2023 and 2032. The easy follow-up of patients using telemonitoring solutions and the augmented access to internet services will continue increasing telemedicine delivery. Learn more about this in our blog Optimize your telemedicine appointments with these best practices.

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Billing Communication Appointments Medication 52