Rich Strobel

Check out this quick and insightful review of the latest updates from CMS, brought to you by the #Michigan Health & #Hospital Association (MHA)! 🚑📊 The proposed #Medicare 2025 Outpatient Prospective Payment System rule includes a net 2.3% increase, new service additions, the adoption of three measures related to health equity and more: https://lnkd.in/gS8rTHEr #HealthcareUpdates #CMS #Medicare2025 #MHA #OPPS

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ON-DEMAND WEBINAR: Is your RCM partner up to today’s security challenges? If you’re unsure, it’s time to find out. Watch to uncover how recent cybersecurity events have refocused vendor-selection requirements and what to evaluate during review.  #Cybersecurity #RevenueCycleSecurity #RCMSecurity

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According to Experian Health’s State of Claims 2022 report, 30% of respondents say claim denials are increasing between 10-15% year over year. Read the latest blog post to learn how Claim Scrubber software can help #healthcare providers submit clean claims every time: https://lnkd.in/gBir_M5W #claimsmanagement

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The Change Healthcare hack opens the door to the likelihood of unprecedented fraud. Boe Hartman, Nomi Health's co-founder and CTO, outlines five immediate threats that demand attention. These scenarios aren't just theoretical - they're blueprints for impending chaos: https://lnkd.in/gWEGdUiA MedCity News #ChangeHealthcare #DataBreach

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BLOG ALERT 🚨 Check out our latest blog on - The best offense is a good defense: The financial impact of claim denials on FQHCs. https://hubs.li/Q02G0VBm0 #FQHC #RevenueCycle #RCM #BLOGS #Synergy Billing

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🔹 Medicare Advisors: Your Trusted Partner in Medicare Solutions 🔹 Are you turning 65 soon? It's time to get informed about Medicare! 🎉 Here’s some key advice to ensure you're on the right path: Understand Your Options: Medicare comes in different parts – Part A, Part B, Part C (Medicare Advantage), and Part D (prescription drug coverage). Make sure to explore what each part covers and how it fits your healthcare needs. Enroll On Time: Don’t miss your Initial Enrollment Period (IEP)! It starts 3 months before you turn 65 and ends 3 months after your birthday month. Missing this window could lead to penalties and gaps in coverage. Compare Plans Annually: Your healthcare needs might change, and so do Medicare plans. Review your plan annually during the Open Enrollment Period (October 15 - December 7) to ensure you're getting the best coverage and value. Seek Professional Help: Navigating Medicare can be overwhelming. At Medicare Advisors, we’re here to help you every step of the way. Our experts will provide personalized advice tailored to your unique situation. Stay Informed: Medicare rules and benefits can change. Stay updated with reliable sources and don’t hesitate to reach out to us for the latest information and guidance. 💬 Have questions? Need assistance? Contact Medicare Advisors at +1 (877) 255-0284 or visit our website at medicareabc.com. Remember, the right Medicare plan can make a significant difference in your health and finances. Let’s make sure you’re covered and confident in your choices! 💙 #MedicareAdvisors #MedicareMadeEasy #Turning65 #Healthcare #SeniorCare

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Check out the latest product release notes from RevenueWell for March 2024: Introducing Dental Insurance Verification! ✅ Now seamlessly integrated within RevenueWell, you can effortlessly confirm your patients' insurance eligibility, coverage history, benefit frequencies, and comprehensive breakdowns—all within our platform. What sets this feature apart? It retrieves data directly from provider portals, sidestepping clearinghouses, ensuring not only accuracy but also reliability in the information you receive. Say goodbye to manual verification processes and hello to streamlined efficiency with RevenueWell's Dental Insurance Verification feature. Discover how this innovation can transform your practice! 👇 #dentalpractice #insuranceverification #dentistry

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Price transparency is a fascinating category that's undergone some significant changes over the past few years as a result of regulatory changes. In 2021, CMS stepped in to require both hospitals and payers to publish “machine-readable files” (MRFs) that contain charges, charge descriptions, and rates for insured and self-pay patients across a wide range of service codes. In response to the influx of hospital- and payer-provided MRFs, a number of companies, including Mathematica, Payerset, Serif Health, SumHealth, Trek Health, TALON, Turquoise Health, and Visible Charges, LLC, prepared to ingest this data and actually make it legible across a range of use cases. The differentiation between price transparency vendors initially came down to the quality of data, and vendors built robust pipelines using heuristics and data science to filter out irrelevant data. But vendors are aware that more competitors could drive down prices for high-quality data and are focused on moving downstream to build products and services incorporating price data for useful applications. To succeed in this space, vendors need to marry data quality with the requisite tooling for contract negotiations. But it seems the real winners here will ultimately be providers and payers, who stand to benefit from streamlined processes and less reliance on contracting consultants. We've covered this in more detail in this week's market map: https://lnkd.in/eVXX7Rpy

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We here at TALON appreciate being included on Elion's price transparency vendor category overview. But we would like to ensure that the various stakeholders within the healthcare industry are aware of what drives us. Although we have developed significant expertise curating and publishing high-quality price transparency for both payers and providers, our primary goal is not to become the system of record for negotiating contracts between payers and providers. TALON's mission is to create a market-driven healthcare system in the United States and supply innovative, consumer-centric tools that educate, empower, and incentivize patients to navigate to low-cost, high-quality, accessible healthcare providers. The real winners, in our eyes, will be patients benefiting from accurate, personalized pricing data throughout their healthcare journey. TALON is looking to lead the necessary paradigm shift to mitigate wasteful spending and drive competition between and amongst payers and providers for the benefit of the patient. #healthcare #healthcarecosts #pricetransparency #healthcareconsumerism #patients

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The Center for Medicare and Medicaid Services (CMS), which enforces hospital pricing transparency and transparency in coverage mandates, has always intended for this data to be used by the most important stakeholders in the medical system: the patients. While hospital pricing transparency data structure has improved in readability with annual updates, transparency in coverage data - which mandates monthly updates on negotiated rates with all in-network and out-of-network entities covered by payers, is far less accessible. Aggregating all pricing data into one single platform and automating its ingestion while dynamically updating with publishing timelines would emerge a picture of the healthcare pricing market for any scale. Thereby allowing any stakeholder in the healthcare system: the patient, provider, payer, or care system to estimate the true costs of their intended decisions. To realize this vision, our focus has produced an atlas of pricing data from publicly available pricing data from sources, including hospital pricing transparency, transparency in coverage data, and both state and federal level pricing data. While numerous applications already exist for payers and care systems to take advantage of this data, which our atlas also allows - our interface, coupled with our team of physicians, is driven to develop applications of our atlas to enrich the interaction between patients and their providers. At its core, healthcare is the conversation between patients and those who care for them. Our intuitive tool allows both to engage with each other and optimize expected care costs - creating a new landscape for shared decision-making. With our active physician team, we are creating this clinical context for the atlas and are excited to share what we are working on soon. Stay connected with us at sumhealth.org. Thank you Elion for the feature! #Pricingtransparency #Transparencyincoverage #CMS #Patientsfirst

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#Medicaid plans provide a much-needed safety net for vulnerable populations. While Medicaid budgets are always uncertain, and recent redeterminations have shrunk enrollment, the future is bright. In a new blog, Joyjit Saha Choudhury explores five post-redetermination growth opportunities for managed Medicaid plans. #healthcaremanagement https://lnkd.in/gR_DBRx2

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Make sure to clear your calendar for an hour today at 2pm ET! Join this live webinar on Medicaid Fragmentation hosted by Medicaid Health Plans of America (MHPA) to hear from N. Rachel Bauch (UnitedHealthcare), Mikal Sutton (Blue Cross Blue Shield Association), Christine M. Burrows, MD (UC Health), Ryan Van Ramshorst (Texas Health and Human Services), and Bob Bollinger (Johns Hopkins Medicine) in this conversation moderated by our CEO, Sebastian Seiguer, JD, MBA. The panel will discuss how to leverage linkage to care and public health strategies to bridge the gaps in Medicaid. Register here: https://lnkd.in/eECqumCY 𝐃𝐢𝐬𝐜𝐥𝐨𝐬𝐮𝐫𝐞: 𝘛𝘩𝘦 𝘑𝘰𝘩𝘯𝘴 𝘏𝘰𝘱𝘬𝘪𝘯𝘴 𝘜𝘯𝘪𝘷𝘦𝘳𝘴𝘪𝘵𝘺 𝘩𝘢𝘴 𝘢 𝘧𝘪𝘯𝘢𝘯𝘤𝘪𝘢𝘭 𝘪𝘯𝘵𝘦𝘳𝘦𝘴𝘵 𝘪𝘯 [𝘚𝘤𝘦𝘯𝘦] (𝘧𝘰𝘳𝘮𝘦𝘳𝘭𝘺 𝘦𝘮𝘰𝘤𝘩𝘢), 𝘢 𝘵𝘦𝘤𝘩𝘯𝘰𝘭𝘰𝘨𝘺 𝘵𝘩𝘢𝘵 𝘸𝘢𝘴 𝘪𝘯𝘷𝘦𝘯𝘵𝘦𝘥 𝘢𝘵 𝘵𝘩𝘦 𝘑𝘰𝘩𝘯𝘴 𝘏𝘰𝘱𝘬𝘪𝘯𝘴 𝘜𝘯𝘪𝘷𝘦𝘳𝘴𝘪𝘵𝘺. 𝘛𝘩𝘪𝘴 𝘧𝘪𝘯𝘢𝘯𝘤𝘪𝘢𝘭 𝘪𝘯𝘵𝘦𝘳𝘦𝘴𝘵 𝘪𝘯𝘤𝘭𝘶𝘥𝘦𝘴 𝘦𝘲𝘶𝘪𝘵𝘺 𝘪𝘯 𝘵𝘩𝘦 𝘤𝘰𝘮𝘱𝘢𝘯𝘺 𝘢𝘯𝘥 𝘦𝘯𝘵𝘪𝘵𝘭𝘦𝘮𝘦𝘯𝘵 𝘵𝘰 𝘳𝘰𝘺𝘢𝘭𝘵𝘪𝘦𝘴. 𝘋𝘳. 𝘉𝘰𝘭𝘭𝘪𝘯𝘨𝘦𝘳 𝘪𝘴 𝘢𝘯 𝘪𝘯𝘷𝘦𝘯𝘵𝘰𝘳 𝘰𝘧 𝘵𝘩𝘦 𝘵𝘦𝘤𝘩𝘯𝘰𝘭𝘰𝘨𝘺, 𝘢𝘯𝘥 𝘩𝘦 𝘩𝘢𝘴 𝘦𝘲𝘶𝘪𝘵𝘺 𝘢𝘯𝘥 𝘢 𝘳𝘰𝘺𝘢𝘭𝘵𝘺 𝘪𝘯𝘵𝘦𝘳𝘦𝘴𝘵 𝘪𝘯 [𝘚𝘤𝘦𝘯𝘦]. 𝘏𝘦 𝘪𝘴 𝘢 𝘮𝘦𝘮𝘣𝘦𝘳 𝘰𝘧 𝘵𝘩𝘦 [𝘚𝘤𝘦𝘯𝘦] 𝘣𝘰𝘢𝘳𝘥 𝘰𝘧 𝘥𝘪𝘳𝘦𝘤𝘵𝘰𝘳𝘴 𝘢𝘯𝘥 𝘪𝘴 𝘢 𝘤𝘰𝘯𝘴𝘶𝘭𝘵𝘢𝘯𝘵 𝘵𝘰 𝘵𝘩𝘦 𝘤𝘰𝘮𝘱𝘢𝘯𝘺. 𝘛𝘩𝘦𝘴𝘦 𝘤𝘰𝘯𝘧𝘭𝘪𝘤𝘵𝘴 𝘰𝘧 𝘪𝘯𝘵𝘦𝘳𝘦𝘴𝘵 𝘢𝘳𝘦 𝘣𝘦𝘪𝘯𝘨 𝘮𝘢𝘯𝘢𝘨𝘦𝘥 𝘣𝘺 𝘵𝘩𝘦 𝘜𝘯𝘪𝘷𝘦𝘳𝘴𝘪𝘵𝘺 𝘪𝘯 𝘢𝘤𝘤𝘰𝘳𝘥𝘢𝘯𝘤𝘦 𝘸𝘪𝘵𝘩 𝘪𝘵𝘴 𝘤𝘰𝘯𝘧𝘭𝘪𝘤𝘵-𝘰𝘧-𝘪𝘯𝘵𝘦𝘳𝘦𝘴𝘵 𝘱𝘰𝘭𝘪𝘤𝘪𝘦𝘴.

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#PracticeManagement: In a recent report, 73% of #Healthcare leaders surveyed said claims denials increased in 2023. Modern technology like automation and #AI can help improve the claims management process and increase the success of clinical denial appeals. Read more here: https://bit.ly/3KYNMEL

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