Insights and Innovations in Revenue Cycle Management
Three Years Later: What Providers Have Learned from the No Surprises Act
It’s been three years since the No Surprises Act (NSA) took effect, reshaping how providers, payers, and patients navigate out-of-network billing and reimbursement. While the goal of protecting patients from unexpected medical bills is widely supported, the ongoing...
The Growing Frustration with Payers: How Claim Denials Impact Healthcare Providers
Claim denials continue to be a major source of frustration for healthcare providers, leading to financial strain, administrative burden, and delays in patient care. Despite efforts to streamline reimbursement processes and improve payer-provider relationships,...
The Future of RCM: Navigating the Surge in Outsourced Revenue Cycle Solutions
The revenue cycle management (RCM) industry is rapidly evolving, with market projections estimating that the RCM vendor market could reach nearly $1 trillion globally within the next decade. According to a recent report by HealthLeaders, the increasing complexity of...
Independent Dispute Resolution (IDR): What Every Provider Needs to Know in 2025
The Independent Dispute Resolution (IDR) process has become essential for healthcare providers seeking fair reimbursement under the No Surprises Act (NSA). As 2025 unfolds, providers—especially those in freestanding emergency rooms (ERs) and emergency medicine...
8 Revenue Cycle Management Trends to Watch in 2025
As the healthcare industry continues to evolve, revenue cycle management (RCM) must adapt to new challenges and opportunities. In 2025, trends like patient-friendly billing, AI-driven automation, and regulatory changes will reshape how healthcare providers manage...
Medicare Fee Schedule Cuts for 2025: What It Means for Healthcare Practices
On January 1, 2025, new Medicare Physician Fee Schedule (PFS) updates will take effect, bringing both challenges and opportunities for healthcare practices. While these changes include significant pay cuts, there are also policy updates that could benefit practices...
CY 2025 Medicare Physician Fee Schedule: Key Updates
On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the CY 2025 Medicare Physician Fee Schedule (PFS), outlining critical updates that will impact Medicare Part B payments starting January 1, 2025. These updates are...
The Nation’s Search for a Solution to Surprise Billing Continues
Surprise medical bills have been a contentious healthcare issue, creating patient stress and complications for providers. Despite recent legislative efforts to address the problem, the nation is still grappling with finding a comprehensive and effective solution. As...
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