insurer – MD Update

&FRONT Accounting

Revenue Cycle Management (RCM) in Healthcare: Part 2

June 1, 2022June 22, 2022 Adam Shewmaker, FHFMA ■ analytics, ■ claim management, ■ claim submission, ■ patient statement, ■ start, ■ start of claim, â– , analytics, balance of the claim, bill, charge entry, claim denial, claim management, claim submission stage, claim submission stage of the process, clinical function, collection of patient service revenue, collection stage, credentialing, determine insurance eligibility, eligible payment, facet of care, full scope of patient care, healthcare, healthcare professional, healthcare revenue cycle, HIPAA, insurance, insurance eligibility, insurer, itemized list, itemized list of charge, MD-Update #139, opportunity, overview of the revenue cycle process, patient 's visit, patient care, patient collection stage, patient schedule, patient service revenue, patient-centered, patient-centered approach, patient-focused, payment, provider, RCM, RCM process, RCM strategy, RCM team, reduce claim denial, resubmission, revenue, revenue cycle, revenue cycle management, revenue cycle of claim, revenue cycle process, significant point of friction, silo, statement of financial obligation, strategy, uncertainty of expense, vital demographic information

Editor’s Note: Part 1 of Revenue Cycle Management was published in MD-Update #139, April 2022. It is available online at

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Revenue Cycle Management (RCM) in Healthcare: Part 1

April 1, 2022June 22, 2022 Adam Shewmaker, FHFMA additional insurer, apply payment, balance of the patient 's claim, big organizational roadblock, billable party, charge entry, claim denial, claim rejection, claim submission, clinical function, collection of patient service revenue, denial, denial management, determine amount, determine amount of reimbursement, determine cause, determine cause of claim denial, facet of care, full scope of patient care, healthcare, healthcare revenue cycle, insurance, insurance eligibility, insurance verification, insurer, medical appeal, medical code, patient 's claim, patient collection, patient demographics, patient insurance, patient registration, patient service revenue, patient-centered, patient-centered approach, payment, payment denial, provider, RCM, refund, revenue, revenue cycle, revenue cycle management, revenue cycle of claim, secondary claim submission, significant point of friction, submit claim, uncertainty of expense, universal medical code

Healthcare professionals strive to deliver exceptional service and outcomes to their patients throughout every facet of care. A significant point

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Telehealth Services During COVID-19: What to Expect from Payers

August 1, 2020October 19, 2020 Jay Swacker, CPA, CIA, CHC, CHDA amount of time, bill personnel, CMS, commercial payer, COVID-19, COVID-19 public health emergency, COVID-19 temporary guidance, CPT, CPT code, differ state law, eligible telehealth service, guidance, health emergency, insurance, insurer, insurer 's requirement, Medicare, modifier, non-covered service, payer, payer type, physician, place of service code, post-payment, practice 's major payer, practice manager, provider, requirement, service code, telehealth, telehealth claim post-payment, telehealth service, telehealth visit, telehealth-specific, temporary guidance, track insurer 's effective date

Physician practices scrambled to offer telehealth services to patients during the first days of the COVID-19 public health emergency. At

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Significant Amendments to Kentucky’s Health Insurance Utilization Review Laws

November 1, 2019February 21, 2020 Sarah Charles Wright, ESQ ‘12, 12 month ongoing use, amendment, authorization, authorization list, authorization requirement, copays, current FDA information, department of insurance, drug formularies, drug lack evidence, e-prescribing, e-prescribing software, effective date, FDA, FDA 's approved use, FDA 's approved use of the drug, FDA information, health benefit plan, health care service, health insurer, insurance, insurer, Kentucky, Kentucky 's health insurance utilization review, Kentucky health insurer, KRS, list of statute, maintenance drug, MCOs, Medicaid MCOs, medical equipment, necessary health care service, necessary information, new defined term, non-maintenance, non-maintenance drug, non-urgent, non-urgent care decision, patient 's choice, patient 's choice of pharmacy, patient 's PCP, patient receive community-based, payer, PCP, physician, pre-selected pharmacy, preauthorization, Preauthorizations, preauthorized, prescription, prescription drug, prior authorization, prior authorization list, prior authorization requirement, prospective review, provider, provider access, requirement, SB 54, section 1, section 8, section 9, significant amendment, statute, statute chapter, steer prescription, timeframe, UR, UR decision, utilization, utilization review, utilization review process, utilization review statute, utilization review statute govern commercial plan

During the 2019 Regular Session, the Kentucky General Assembly passed Senate Bill (SB) 54, which goes into effect January 1,

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KMA Announces 2019 Legislative Priorities

January 1, 2019 Bruce Scott, MD additional priority issue, advocacy team, authorization, authorization information, board-owned, Care initiative, chronic disease medication, current prior authorization process, disease medication, electronic prior authorization, enhance access, good Care initiative, impact of narrow network, insurer, Kentucky, Kentucky medical association, KMA, KMA support legislation, legal liability system, legislation, legislative priority, liability situation, liability system, medical review panel case, medication-assisted, medication-assisted therapy service, modest step, nonclinical activity, offer physician reimbursement contract, one-year approval, out-of-network, Out-of-Network Billing, parameter of the state constitution, patient 's access, patient cost, physician, physician network, physician recruitment, physician reimbursement contract, practice of medicine, practice staff, prior authorization, prior authorization information, priority, quality healthcare, restore fairness, retroactive denial, review panel case, review time, roadblock, tobacco-free

The Kentucky Medical Association (KMA) has been busy preparing for the 2019 legislative session. Our advocacy team worked with members

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Letter from the Publisher

Health Is a Personal Choice, a Freedom, and a Responsibility

May 1, 2015 Gil Dunn Bensema, cessation program, Deborah Ballard, digital version of MD-UPDATE, Dr. David Bensema, featured physician, Gil Dunn, governor 's program, health obstetrics, hospital group, insurer, internal medicine specialist, Kentucky, Kentucky 's colon cancer screen, KentuckyOne, KentuckyOne health, KMA president, kyhealthnow, MD-UPDATE, MD-UPDATE Reader, MD-UPDATE Reader survey card, Owensboro health, personal choice, prescription drug abuse, smoke cessation program, stakeholder need, stakeholders need, supported cancer screen, Suzanne Rashidian, uglies, unnecessary roadblock

When reading through the proofs of this issue of MD-UPDATE, I was drawn to two quotes by our featured physicians.

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