This week's 5 must-reads for hospital RCM leaders

Here are five articles published by Becker's Hospital Review this week that offer insight on "surprise" balance billing, how to navigate revenue cycle management challenges and more.

1. Senator calls on FTC to investigate 'surprise' medical bills
Sen. Bill Nelson (D-Fla.) urged the Federal Trade Commission to investigate the practice of "surprise" balance billing caused by involuntary out-of-network care as a violation of federal law, reports The New York Times.

2. How to navigate growing RCM challenges in healthcare
During a Navigant roundtable discussion moderated by Molly Gamble, editor-in-chief of Becker's Hospital Review, at the Becker's 5th Annual CEO + CFO Roundtable in Chicago, two health system executives and a healthcare futurist discussed a few RCM challenges and how they are addressing those issues. 

3. Hospitals have 60% overturn rate when appealing RAC claims
Hospitals appealed 45 percent of all Recovery Audit Contractor claim denials in the third quarter of 2016, with 60 percent of those claim denials being overturned in the appeals process, according to the American Hospital Association's third-quarter RACTrac survey.

4. 30% of Americans don't know their deductible, out-of-pocket maximum
American employees are alarmingly uninformed about important details of their insurance plans as well as employer's voluntary benefit programs, according a recent survey from Sun Life Financial.

5. 6 experts share healthcare RCM predictions for 2017
Hospitals and health systems will face a number of revenue cycle management challenges next year as the healthcare industry continues the shift from fee-for-service to value-based care and an increasing number of patients enroll in high-deductible health plans. Six experts give their RCM predictions for next year.

 

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