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Legal

Before California’s QME Template Arrives, Fix the Record Set Behind It

The case for AB 1293 was easy to make. A panel QME issues a report that never addresses apportionment, or answers causation for the shoulder and says nothing about the cervical spine. Somebody requests a supplemental report, which the evaluator has 60 days to produce. Somebody else notices the deposition, which can be set as far out as 120 days. Months come off the claim, the per-page and per-report billing keeps running, and the underlying medical opinion has not moved.

Before California’s QME Template Arrives, Fix the Record Set Behind It Read Post »

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Revenue Cycle

What is Driving the Sudden Rise in Revenue Cycle Automation?

The rise of healthcare revenue cycle automation is being driven by increasing hospital labor costs, denial volumes, and payer complexity, which are all growing at a rate greater than that of staffing budgets.

What is Driving the Sudden Rise in Revenue Cycle Automation? Read Post »

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Legal

AI in Medical Record Review: What Is Actually Solved, What Is Not, and How to Tell the Difference

Three years ago, telling a workers’ compensation defense firm that AI could build a medical chronology was a sales pitch. Today it is an assumption. Every serious vendor in this market has an extraction engine, and most have had one long enough to have worked the obvious bugs out of it.

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SB 171 and SIBTF: What Changed, What Is Being Misread, and How to Screen Your Open Files
Legal

SB 171 and SIBTF: What Changed, What Is Being Misread, and How to Screen Your Open Files

It arrived as a budget trailer bill, so it moved through the budget process rather than the ordinary policy committee route, and it makes the largest change to the Subsequent Injuries Benefits Trust Fund in decades. It adds Labor Code sections 4750, 4754.1, 4754.2, 4754.3, 4757, and 4758, amends sections 4751, 4753, 4753.5, 4754, and 4755, and makes the 60-day reconsideration rule in section 5909 permanent.

SB 171 and SIBTF: What Changed, What Is Being Misread, and How to Screen Your Open Files Read Post »

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Revenue Cycle

What Is Revenue Cycle Management? A Practical Guide for Specialty Practices

Revenue cycle management (RCM) is the financial process healthcare providers use to track a patient’s care from the first appointment to the final payment. It covers visit capture, insurance eligibility, coding, claim submission, payment posting, denial management, and reconciliation. Run as one connected cycle, it decides how much of the revenue a practice earns actually gets collected.

What Is Revenue Cycle Management? A Practical Guide for Specialty Practices Read Post »

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