On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Medicaid and Children’s Health Insurance Program Managed Care Access, Finance and Quality Final Rule, a final rule that ...

With the announcement of the nursing home minimum staffing rule, I asked myself the same question as operators nationwide: how on earth are we going to pay for this? Even if nursing homes could find ...

Contract negotiations adhere to a rule that 80 percent of time should be used to prepare for the negotiation and 20 percent to negotiate. To help be more effective in achieving results when you ...

Here are seven best practices from managed care contracting experts to help you get paid fairly by third-party payors. 1. Give yourself ample time to negotiate a contract. To convince a payor that you ...

Workforce shortages, regulatory complexities and economic challenges have put hospitals and health systems under immense pressure to improve operational efficiency, accelerate payments and reduce ...

Coding of physician office visits can be very confusing – and is ever-changing. Every year, regulations and guidelines change, and it is difficult for providers to keep up. Most groups have coding ...

Who Are the Top Companies in the Managed Care Indu... Who Are the Top Companies in the Managed Care Indu... Managed care organizations (MCOs), which primarily offer medical and pharmaceutical benefit ...