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NSB Monthly Letter - October 2024
Resources
07th October
NSB Monthly Letter - October 2024
NSB Monthly Letter - October 2024
Healthcare Headlines : Payer Disputes,Regulatory changes and Industry changes
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The No Surprises Act is facing legal challenges that require equal consideration of the Qualifying Payment Amount in payment disputes, prompting regulatory revisions and a call for greater accountability in insurer reimbursements.
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Blue Cross was fined $8.5 million by California for failing to address and resolve provider claims disputes in a timely manner, and the company is implementing corrective measures to improve its dispute resolution processes.
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Hospitals are struggling with increasing administrative burdens and delayed payments from Medicare Advantage plans, particularly from insurers like UnitedHealthcare, leading some to reconsider their participation in the program.
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Common Spirit’s CFO stressed the need to improve payer relationships as the organization faces significant payment delays, with over $100 million in disputes, despite efforts to enhance revenue cycle performance.
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Claims denials are increasing due to more frequent payer policy changes, longer reimbursement times, and rising claim errors, placing significant pressure on healthcare providers' revenue cycle departments.
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UnitedHealth Group reported a Q3 2024 net income of nearly $6.1 billion and total revenues of $100.8 billion, reflecting strong growth despite a $1.7 billion hit from a cyberattack.
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UnitedHealth Seeks Smoother Hospital Relations, Lower Costs. CEO Witty aims for collaboration to reduce friction and achieve more competitive rates.
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