Medical billing and coding rules and payer requirements have become more and more detailed and restricting. The margins within which physician practices operate continue to decrease. Electronic medical records, practice management systems, and other automated tools used by practices require too much time and manual effort to use correctly.
Read more »How Can You Reduce Your Costly Billing Mistakes?
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Key Takeaways For Physicians From Value-Based Reimbursement
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In the rapidly changing healthcare landscape, payers are asking medical providers to shift from volume-based care; the fee for service to a value-based reimbursement structure. This evolution toward value-based reimbursement benefits the patient, the healthcare provider as well as the payers.
Read more »Why You Should Understand the Basics Of Bundled Payment In Healthcare?
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Bundled payments sooner rather than later, is likely to become a more common thing in the healthcare industry. Bundled payment policies are being leveraged to incentivize improved care coordination, quality, patient safety, and cost proficiency in a system which is badly in need of developments in these areas.
Read more »Risk Adjusted Hierarchical Condition Category (HCC) Coding
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HCC is a payment model created by the Balanced Budget Act of 1997. Implemented by the Center for Medicare and Medicaid Services in 2003, the payment model will identify the individual with chronic illness and assign them to a risk factor score. This risk factor score gives CMS a specific plan out that channelizes the payment method for the risked beneficiaries enrolled.
Read more »Get A Better ROI On Your Medical Claim Status
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Medical billing is extremely challenging, and there is no reason why the medical claim status of reimbursement can’t improve. The denials can be minimized and can achieve a better ROI on your medical claim status.
Read more »How To Effectively Schedule Patient Appointment?
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Your front desk receptionist will most important factor for revenue growth through patient care and timely scheduling without any delay.
Read more »Top 5 Challenges with Healthcare Revenue Cycle Management
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The non-medical works include taking care of all the documentation, eligibility verification, demographic entry, billing and coding and filing of the medical claims. If a single step is overlooked, the claim will be rejected. Thus, a disorganized revenue cycle management can lead to a stockpile of uncollectible with no proper process to streamline it.
Read more »Understanding Medicare’s Outpatient Mental Health Treatment
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Unfortunately, when you offer mental health services to Medicare patients, your usual Medicare payments are reduced. By holding the patient responsible for the difference between the amount paid by Medicare and the full allowed amount, you still be able to collect what he usually would for the service.
Read more »Ostomy Documentation Tips
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Medical records must contain adequate, clear documentation that supports the medical necessity of the amount ordered and billed. The quantity of ostomy supplies needed by a beneficiary is determined primarily by the type of ostomy, its location, its construction, and the condition of the skin surface surrounding the stoma.
Read more »Critical Care Services and Medical Necessity
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Critical care services encompass both treatments of ‘vital organ failure’ and ‘prevention of further life-threatening deterioration of the patient’s condition.
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