Becker's Payer Issues | Payer News

Health systems process enormous volumes of protected health information every day, which makes every facility a high-value target. Most IT teams already treat encryption as a baseline defense. Fewer can prove the encryption they rely on actually works as promised.…

Federal auditors found that 13 percent of the prior authorization requests Medicare Advantage plans denied met Medicare coverage rules, care that likely should have been approved. The pressure that creates lands on the revenue cycle. This report shows how health…

Hospital revenue loss rarely begins with a bad claim. It often begins days or weeks earlier, when a service is scheduled before authorization requirements are confirmed, documentation is incomplete or the final service no longer matches what was approved. That…

A fully staffed perioperative team is essential to safe, efficient surgical care — and rising procedural demand, clinician shortages and anesthesia constraints keep testing it. But workforce shortages are only half the problem. The other half is deployment: getting the…