Gold Carding Programs Are Meant to Improve Prior Authorization. Are They Working?
Several states and insurers have gold carding programs to streamline prior authorization. However, some say they're falling short.
CMS Lowers No Surprises Act Fee After Court Nixes Price Hike
CMS recently announced that it will change the administrative fee that providers and insurers must pay when initiating a reimbursement dispute under the No Surprises Act — the agency is lowering the fee from $350 to $50. This move came a week after the Texas Medical Association won a court case challenging HHS over its 600% price hike on the fee.
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Finding the best analytics tools for health care revenue management can revolutionize operational processes. Compare the leading software options to discover helpful team resources.
Texas Medical Association continuing opposition to No Surprises Act ruling for determining out-of-network pricing
The Texas Medical Association (TMA) filed a brief on Monday to further oppose the ruling on the No Suprises Act that currently allows aribtrators to use the average in-network rate to determine out-of-network cost.
Being “complaint proof” on information blocking won’t be easy for providers, vendors
The HHS' information blocking rule goes into effect Monday, and for nearly a year, providers and IT vendors have been racing to prepare. But they have faced several hurdles along the way, including figuring out how to handle scenarios that could make them non-compliant.