by Gustavo Matheus | Nov 18, 2014 | Contract Review & Negotiation, Medicaid Reimbursement, Revenue Cycle Management
Managed care revenue fuels hospital operations, which is why hospitals’ managed care contracts require careful maintenance. Still, the firm sometimes sees hospital clients with stale five- or 10-year-old contracts – and costly problems left unresolved. As a general...
by Gustavo Matheus | Oct 28, 2014 | Hospital Revenue Cycle, Managed Care - General, Payer Reimbursement, Probate
by Ron Landsman, Esq. – Guest Contributor Note from Gustavo Matheus: When dealing with high-cost medical cases, oftentimes hospitals lose significant revenue simply because they fail to create special needs trusts. Since such an omission results in many missed...
by Gustavo Matheus | Sep 23, 2014 | Healthcare Reimbursement, Hospital Revenue Cycle, Managed Care - General, Payer Reimbursement
Given that a patient’s health records reveal highly personal and sensitive details, federal and state law protects patients against the unwanted disclosure of their private health information. And for healthcare facilities and physicians, a particular and recurring...
by Gustavo Matheus | Aug 26, 2014 | Healthcare Reimbursement, Hospital Revenue Cycle, Managed Care - General, Payer Reimbursement
The purpose of the many state prompt-pay laws on the books is to ensure that health plans pay undisputed medical charges without delay or face steep late-payment interest rates in addition to the claim’s principal amount. For added protection against delinquent...
by Gustavo Matheus | Jul 22, 2014 | Denied Claim Appeals
In contract law, disproportionate forfeiture – paying nothing if a service is not completed precisely as agreed under the contract – is considered a penalty because of its failure to take into account the percentage of work completed. Disproportionate forfeiture and...
