News

Patrice Wolfe, MBA is CEO of AGS Health of Washington, DC.

TAMPA, Fla. and COLLINSVILLE, Conn. – April 26, 2023 – FutureRx (FRx) and Nuwae, a member of the Goodrootcommunity of companies, announced today the addition of Nuwae’s pharmacy and medical rebate services and software to the FutureRx Marketplace, providing FRx health plan and pharmacy benefits manager (PBM) customers with streamlined access to rebate optimization and management solutions. With Nuwae on the FRx Marketplace, FRx customers can easily integrate solutions designed to lower prescription drug costs for both patients and payers from a company focused on solving the issues that drive medication prices to astronomical levels – thereby lowering out-of-pocket costs and providing equitable access and outcomes for stakeholders.

When health systems are immersed in data related to billing, denials, internal audits, and external payer audits, it can be overwhelming to track, manage, and process what is an overwhelming amount of raw data. Creating a value-generating revenue integrity team and pairing it with technology is the answer to harnessing that data and using it to positively affect the tight margins experienced by many healthcare organizations.

While this might seem like a bold statement, the only way to productively use your data is to employ sophisticated analytics that will provide actionable insights on how to improve billing compliance and maximize revenues.

Nashville - AGS Health works with scores of hospitals providers on revenue cycle management and helping sure organizations get money more quickly, but the company is also working with organizations on health equity.

Cheryl Cruver, chief revenue officer of AGS Health, spoke about the growing interest in health equity in a conversation with Chief Healthcare Executive® at the ViVE Conference.

WASHINGTON, D.C. – March 29, 2023 – AGS Health, a leading provider of tech-enabled revenue cycle management (RCM) solutions and strategic growth partner to healthcare providers across the U.S., has earned recertification of its KLAS Cybersecurity Transparent designation. It was one of 25 healthcare vendors to achieve or sustain their designation, which AGS originally earned in 2022 after completing a voluntary risk assessment process and program from Censinet and KLAS Research.

Revenue cycle management solutions leader AGS Health is pleased to launch operations in Manilla, Philippines. Serving as a strategic growth partner to more than 100 major healthcare providers across the U.S., the expansion will offer AGS Health and its customers increased access to global talent.

MDaudit, an award-winning provider of technologies and analytics tools that enable premier healthcare organizations to retain revenue and reduce risk, sees the retirement of its long-time president and CEO, Peter J. Butler, effective March 31, 2023. Stepping into the CEO role will be the company’s current COO, Ritesh Ramesh.

Butler will continue serving on MDaudit’s Board of Directors and as an investor, advising on future investments and growth opportunities for the company. He has been with MDaudit for 30 years, including the past 16 as president and CEO.

The Office of Inspector General (OIG) makes no secret about the investigative target it has placed on Medicare Advantage plans and the use of unsupported hierarchical condition category (HCC) assignments. Over the past 18 months, its investigations have netted clawbacks as high as $54.3 million from SCAN Health Plan.

Nor are health plans the only ones at risk when it comes to high-risk codes. While payers may be the ones writing the checks for improper reimbursements, the providers who submitted the claims are being targeted with audits that will inevitably result in repayments to the health plan.

Healthcare organizations undoubtedly felt a sense of relief as 2022 faded in the distance, taking with it a devastating financial performance that resulted in negative profit margins for more than half of U.S. hospitals – the worst year hospitals have faced since the start of the pandemic, according to Kaufman Hall. Not only were operating margins down for most of 2022, but hospitals also struggled with higher labor costs in a more competitive market plagued by chronic clinical and administrative skill shortages.

Physician practices fared no better, with 90% saying that soaring expenses outpaced revenues last year, according to a survey by the Medical Group Management Association. Staffing and labor costs were cited most often as the source of rising costs. Other common culprits were lower reimbursement rates, significant increases in lab supply and drug costs, higher utility costs, lower patient volumes, and rising malpractice premiums.

On March 13, the HIMSS EHR Association submitted its comments to the Centers for Medicare and Medicaid Services on its Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule.

Over the years, computer-assisted coding (CAC) has proven its ability to boost revenue team productivity and accelerate critical decision-making while reducing denials, missed charges, and low-risk scores. CAC also increases coder productivity and code capture, and enables flexible and scalable coding to increase accuracy, efficiency, productivity, and flexibility.

Indeed, these benefits are why we are seeing a rapid uptick in adoption of CAC on the professional side of the healthcare house. Once reserved primarily for facility-based coding, today’s CAC solutions are stepping up to fill the void created by the chronic coder shortage that is impacting both facility and professional fee coding while helping to maximize the performance of any healthcare organization’s coding operations with improved throughput and quality – increasing coder productivity by 25%-45% and decreasing Discharged Not Finally Coded (DNFC) by between one and three days.

WASHINGTON, D.C. – March 7, 2023 – Revenue cycle management solutions leader AGS Health is pleased to announce the launch of operations in Manilla, Philippines. Serving as a strategic growth partner to more than 100 major healthcare providers across the U.S., the expansion will offer AGS Health and its customers increased access to global talent.

Identified as one of the most popular outsourcing destinations in the world, the Philippines is known for the quality of skills offered in the business process outsourcing (BPO) sector. With strong medical backgrounds and voice-based skills, AGS Health aims to focus on supporting end-to-end accounts receivable services. “By augmenting our service line with patient calls, responding to patient queries, and timely patient follow-ups, the addition of our Philippines operations represents an exciting added value to our customers,” said Patrice Wolfe, CEO of AGS Health.

Revenue cycle management company AGS Health opened an office in Manila, Philippines.

AGS said in a March 7 news release the expansion will support end-to-end accounts receivable services.

The HIMSS EHR Association this week sent a letter asking the Centers for Medicare and Medicaid Services to extend the comment period on its Advancing Interoperability and Improving Prior Authorization Processes proposed rule by at least 45 days.

Health tech companies are in a tizzy: After years of letting companies roll out software tools to guide patient care with little oversight, the Food and Drug Administration is taking a tougher stance.

In September, the FDA announced its intentions to regulate many of these AI-powered clinical decision support (CDS) tools as devices — which regulators say has always been their plan and within their purview. But the industry says it was blindsided by the move. In a fierce rebuttal, the Clinical Decision Support Coalition filed a petition earlier this month asking the FDA to withdraw the final CDS guidance, arguing regulators are overstepping their bounds by trying to police medical practice. They also claim the FDA’s move violates the 21st Century Cures Act, a 2016 law that says tools that “provide limited clinical decision support” don’t count as medical devices.