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adults with private health insurance between 2017 and 2019. Despite this, the mean reduction in cost-sharing following a successful appeal was still lower for Black and Hispanic patients than for White patients. “It Yet the burden to resolve them often falls on patients or time-strapped health care practices.
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Biggest Healthcare Data Breaches in April 2025 In April, 27 data breaches of 10,000 or more records were reported to OCR, including 11 data breaches of 100,000 or more records. California was the worst-affected state with 11 data breaches, followed by Illinois with 8 breaches, and Ohio, Tennessee, and Texas, which each had 4 data breaches.
Direct primary care (DPC) offers stable revenue through subscription fees, eliminating routine insurance claims and enhancing patient access. Once the insurer processes the claim, any remaining patient responsibility is automatically charged to the credit card on file, drastically reducing manual collections and bad‑debt write‑offs.
These improvements reflect stabilization following pandemic-related disruptions and cost pressures. However, hospitals with a high share of Medicaid patients continue to see lower operating margins (2.3%) compared to those with more commercially insured patients (7.0%). and operating margins to 5.2%.
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Behavioral health providers managing both clinical care and business operations face unique challenges: complex prior authorization requirements, extensive documentation standards, and insurance coverage barriers. Insurers denied 19% of in-network claims in 2023 , according to the Kaiser Family Foundation.
Practices that take a proactive stance turn claim denials into early warning indicators that speed up payments and streamline everyday operations. Industry data showed that insurers on HealthCare.gov denied about 19% of in-network claims in 2023 ; that’s $73 million out of $319 million in claims filed.
The hackers encrypted files and stole data such as names, addresses, telephone numbers, email addresses, dates of birth, demographic information, Social Security numbers, drivers license numbers, medical record numbers, health information, payment information, and health insurance information.
In follow-up work under review, researchers found that altering the style or tone of a message didn’t impact human clinicians’ judgment, further underscoring the fragility of LLMs. Human physicians were not affected by the same changes.
Lords bid to exempt practices from NI increases Practices could still be exempted from the increase in employers National Insurance rates following a vote in the House of Lords. The Lords voted to amend the National Insurance Act to protect health and care providers. It states that the dispute with Government may be over.
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pay rise for GPs in 2025/26. The BMA has called for an increase of 20% plus inflation for salaried GPs, alongside a commitment to annual uplifts in the following years to reverse the effects of over a decade of underfunding. Im not getting my hopes up! Before Christmas, the Government announced its proposal for a 2.8%
Verisource Services, an employee benefits administration service provider, has determined that a previously announced data breach was far worse than initially thought and has affected up to 4 million individuals.The Houston, Texas-based company detected a hacking incident on February 28, 2024, that disrupted access to some of its systems.
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They expect clear communication about AI’s role in diagnosis, treatment and even follow-up care.” AI and financial tools: Proceed with caution The survey also explored patients’ comfort levels with AI in billing and insurance — and got generally mixed feedback.
Wrapping up your practice for the New Year includes: Reconciling all accounts accurately Sorting out outstanding claims Updating patient information These measures will prevent discrepancies that lead to financial loss, reduce mistakes, and speed up the claim approval process, allowing your practice to continue running without glitches.
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The BMA welcomed the news, signalling that the extra money might help to relieve the pressure that practices face from the National Insurance increase. is clear the system is broken, which is why we are slashing red tape, binning outdated performance targets, and instead freeing doctors up to do their jobs.
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We’re shifting our focus to the reports you should run regularly in 2025 to keep a pulse on your practice’s ongoing performance. By consistently monitoring these key areas, you can ensure operational efficiency, financial health, and compliance, ultimately enhancing the quality of care you provide to your patients.
Following the surge, investment plummeted. What were left with entering into 2025 are a smorgasbord of solutions clamoring to attach themselves to traditional enterprise incumbents (Health Insurance Providers, Electronic Health Records, Hospital Systems). Those regions are ripe for follow-on expansion and digital scale.
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The first smartphone was launched by IBM the following year in 1992 known as the IBM Simon. Now in 2025, smartphones are ubiquitous, landlines more cut than connected, and texting is the way people communicate. Senate’s 2025 Reconciliation legislation. The Telephone Consumer Protection Act (TCPA) was put into law in 1991.
Were shifting our focus to the reports you should run regularly in 2025 to keep a pulse on your practices ongoing performance. It categorizes unpaid patient invoices and insurance claims by age, typically in 30-day increments. In one of our past blogs, we delved into the end-of-year reports you should run in your practice.
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Change of rules creates 1,500 GP jobs More than 1,500 GPs have found jobs following changes to practice funding rules over the last year. In a briefing earlier this week, it advised practices not to sign up and warned of a continued expectation for general practice to deliver a range of complex services without proper commissioning.
This necessitates the acquisition of a permanent license, which frequently involves paying a hefty up-front cost. Additionally, in addition to the software requirements, hardware acquisition costs also pile up higher in case of on-premise EHRs as compared to cloud hosted EHR.
I spent 33 minutes on the phone on January 8th, 2025 before I finally navigated the maze that is American healthcare to the extent that a medication that has been prescribed for me by my doctor regularly for several years could be delivered to her office in time for my next appointment.
” With all of these concerns, it’s vital that providers and billing departments understand and follow the key elements of proper medical billing compliance to run a successful practice. Following health insurance policies and procedures. For example, this April 2025, CMS announces 50 new ICD-10-PCS codes (PDF).
Neil Baum, MD Successful practices do not follow others; rather, they make their own paths and follow their own pathways and agendas. Neil Baum, MD Successful practices do not follow others; rather, they make their own paths and follow their own pathways and agendas. Edison said, "I have not failed 10,000 times.
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