Commercial Insurer Accountability
One in three inpatient claims submitted by providers to commercial insurers in first- quarter 2023 weren鈥檛 paid for over three months and 15% of inpatient and outpatient claims were initially denied, according to data from over 1,800 hospitals and 200,000 physicians analyzed by Crowe Revenue Cycle鈥
The March 21 Health & Science article 鈥淢any Americans 鈥 especially those below U.S. poverty level 鈥 are buried in hospital bills鈥 missed a major reason that medical debt has increased in our country: the rise of high-deductible and skinny insurance plans that result in larger out-of-pocket鈥
TOP NEWS
The Senate Health, Education, Labor & Pensions Committee last week held a hearing aptly titled 鈥淓xamining Health Care Workforce Shortages: Where Do We Go from Here?鈥 Clearly, all of our efforts to inform policymakers and the public about the urgent need to address the workforce challenges have鈥
The Doximity digital platform for medical professionals has launched a beta version of ChatGPT to help streamline time-sapping administrative tasks like drafting and faxing preauthorizations and appeals letters to insurers.
AHA filed a friend-of-the-court brief urging the U.S. Court of Appeals for the 9th Circuit to affirm a federal jury鈥檚 unanimous 2022 verdict in favor of Sutter Health and certain affiliates in a lawsuit that alleged the California-based integrated health care network violated federal antitrust law鈥
High inflation and labor shortages, as well as sicker patients who require complex care, and low reimbursement rates combined with continued fallout from a global pandemic have created an unsustainable financial situation for hospitals and health systems around the country. Many face a devastating鈥
The Centers for Medicare & Medicaid Services (CMS) Dec. 12 issued a proposed rule that would implement for 2024 the standards governing health insurance issuers and the Health Insurance Marketplaces. In the rule, CMS proposes changes to the qualified health plan (QHP) network adequacy standards鈥
The Centers for Medicare & Medicaid Services (CMS), proposed new regulations that would streamline and reduce the burden associated with health plan prior authorization processes and improve the electronic exchange of health care information.
The latest news on health plan accountability from the AHA for November 2022.