Monthly Archives: March 2013

The Demands of Value-Based Reimbursement Model to Be Met With Medical Billing Specialists

With many of the healthcare reforms set to take effect shortly or having already been in force, providers may have entered a different phase of operational model, which is called value-based model. The unique feature of value-based model is that … Continue reading

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Insurance Underpayments, the Issue That is Plaguing Orthopedic Billing the Most

Insurance underpayments continues to be a major concern for medical practices across the United States; more so for orthopedic surgeons, who, despite serving in a more critical specialty, find it hard to fully recover their medical cost. Because most of … Continue reading

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Orthopedic Billing Specialist to Take Care of CPT Code Changes Made to Orthopedic Surgery Billing in 2013

This year’s CPT Manual has spelt out extensive coding changes and revisions to orthopedic surgical codes.  In all, there are 500 code changes to the Category I codes, including 251 revisions, 151 new codes and 100 deletions. Moreover, there has … Continue reading

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Negotiating Your Reimbursement Rates during this Phase of Payer Consolidation & Health Insurer Monopoly Power

Physicians’ choice of health plans and contracts seem to be getting fewer and fewer with each passing moment as U.S. health insurance sector, particularly the private sector, witnesses unprecedented payer consolidation, acquisitions, and mergers amongst private health insurance carriers. Besides … Continue reading

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How best are medical practices prepared to address HIPAA breaches?

Contrary to the notion that government’s move to digitize healthcare information would enable healthcare providers, doctors, and insurance companies comply more aptly with HIPAA’s guidelines for patients’ privacy and security, there has been an upsurge in HIPAA breaches with providers … Continue reading

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What Do Stage 2 Meaningful Use Guidelines Have in Store for Radiologists?

Stage 2 meaningful use guidelines are finally out, and radiologists may heave a sigh of relief since most of the ambiguity that existed in Stage 1 about their eligibility and the ways to approach the qualification criterion seem to have … Continue reading

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Medicare Fraud Claims, A New Challenge Even For Honest US Physicians – is Competent Billing and Coding A Way Out?

In 2010, Medicare improper payment amounted to $47.9 billion. Human and Health Services, in 2011, recovered $4.1 billion paid through reimbursements as a result of ‘fraudulent’ or ‘improper’ claims. You may be right if you think you won’t ever be … Continue reading

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