Rules and Regulations Affecting Revenue
A number of payment rule changes and unknown future federal and state regulations loom ahead.
Interpreting Payment Rule and Revenue Cycle Terminology
Understanding terms used in rule sets pertaining to payment for inpatients, which go into effect during the fiscal year effective Oct. 1, as well as outpatient and physician fee services, which go into effect during the calendar year effective Jan. 1.
2022 Proposed OPPS/ASC and PFS Payment Rules: The Impact on Pharmacy
The proposed 2022 outpatient prospective payment system (OPPS)/ambulatory surgery center (ASC) and physician fee schedule (PFS) rule sets impact all pharmacy practices.
Provider, Supply Chain and Payer Negotiations
In today’s fast-paced healthcare industry, naiveté about payers’ requirements coupled with their supply chain stipulations can lead to reimbursement shock!
Preparing for Possible Drug Pricing Changes
The COVID-19 pandemic that has pushed the U.S. healthcare system to its limits and crippled the economy has brought stark attention to the need for new legislation to lower medication prices.
COVID-19 Business Recovery
Life during the COVID-19 pandemic is surreal even after a year. Healthcare organizations are being pressured to do more with less while at the same time contribute revenue to whittle away at staggering losses.
Proposed Payment Rules and Court Rulings
Two court rulings and segments of the proposed OPPS/ASC and PFS rules may require action from providers to recover expenses caused by the COVID-19 pandemic.
Data Integrity Vigilance: Telling Patient Pandemic Stories
While focusing on being prepared, safe and innovative during the COVID-19 pandemic, healthcare providers mustn’t overlook the critical importance of data integrity.
CMS Price Transparency: The Basics
The Centers for Medicare and Medicaid Services (CMS) released its final rule requiring hospitals to disclose payer-specific negotiated rates effective Jan. 1, 2021. Becoming familiar with the rule’s definitions will assist in making necessary changes to be compliant.
Short-Dated Products: Reducing Unsalable Returns and Supply Chain Waste
The glut of soon-to-expire products within the pharmaceutical supply chain is a costly problem impacting multiple stakeholders, but smart technology and innovative inventory management systems offer cost-saving solutions.
