Financial/Revenue Cycle Management

Payers will not only need to comply with the 2024 CMS Final Rule pertaining to materials and content, but they will need to go the extra mile because it affects star ratings, says Ernie Crawford, president and CEO of Crawford Technologies.  

Joe Gagnon, CEO of 1upHealth, talks about how collaborating more on APIs can help providers generate EHR requests for information from payers.  

Also: CloudWave and FDA extend their threat intelligence partnership to offer an open-source vendor assessment framework.

David Smith, CFO of Anatomy IT, says direct oversight must be weighed against investments in new technology.  

The agency says threat actors are targeting organizations' IT help desks with phone calls from a local area code claiming to be revenue cycle or administrator employees. After gaining access, they divert legitimate payments.

Also: Cohere Health expedites prior auth through Epic's Payer Platform.

As Kaiser Permanente closes its acquisition of the Pennsylvania-based IT innovator, Gesinger will be the first health system to join the nonprofit organization, which was created by Kaiser to speed the adoption of value-based care nationwide.

Many healthcare organizations underestimate the expense of on-premises cybersecurity and may miss early signs of an attack if teams don’t know what to look for, says Max Rogers, senior director of the security operations center at Huntress.  

Washington, Maryland and New Mexico have leveraged funding opportunities and regulatory tools to ease the burden on providers still struggling to operate with claims payments disrupted.

The provider saw a 22% decrease in one type of denial and an 18% decrease in another. Those improvements have resulted in more than 30 hours per week in eliminated work for follow-up staff.