Today the healthcare industry is going through a transformative change called “Vertical integration” and its popularity is rising continuously over the US. However, it is observed in most cases that such mergers would lead to higher healthcare costs and a low level of patient satisfaction. As a physician or healthcare organization, you should know about […]
Managed Care plays important role in the delivery of healthcare and it is used to describe a health insurance plan or health care system that coordinates the provision, quality, and cost of care for its enrolled members. Traditionally States have utilized a fee-for-service (FFS) payment system to cover enrollees but now states are also making […]
Healthcare providers implemented telehealth for COVID-19 pandemic widely in the US. According to 2019 Health Center Program Data, 43% of health centers were capable of providing telemedicine (it is a part of telehealth), compared with 95% of the health centers that reported using telehealth during the COVID-19 pandemic. While the largest increase in the use […]
Denial Code CO 50 means that the payer refused to pay the claim because they did not deem the service or procedure as medically necessary. It is a very popular denial code and the sixth most frequent reason for Medicare claim denials. According to a CMS, It is observed that 30% of claims are either […]
Today physicians whether they own their practice or are employed by a hospital or larger health system are facing many challenges in the day-to-day routine. These common challenges include “How to use the EMR efficiently and getting paid”, overburden with administrative requirements, staffing, burnout, etc. despite their devotion to the practice of medicine and the […]
If your Medicaid crossover claims are rejecting it may be due to the address you have on file with Medicare and Medicaid. When Medicare crosses over your claim to Medicaid, address fields like Master address and Pay-to (or remit address) are submitted. If Medicaid does not have the same addresses in their file, Medicaid will […]
CMS recently announced the proposed rules for the ‘Inpatient Psychiatric Facility Prospective Payment System and Inpatient Rehabilitation Facility Prospective Payment System’ for FY 2022. This proposed rule would update the prospective payment rates for IRFs for Federal FY 2022. The proposed FY 2022 IRF Prospective Payment System rule would boost Medicare payments by 1.8%, or […]
In the US, providers are struggling daily basis with healthcare frauds. These frauds generally cost the healthcare industry 3 to 15 percent of the total expenditure in the United States hence healthcare fraud and abuse must be critical. What are healthcare fraud and abuse? Generally, fraud and abuse are referred to describe a range of […]
The physician or other qualified healthcare professional are using CPT codes from the range 99202-99499 which is called Evaluation and management (E/M) codes to represent services offered by physicians. These codes are applicable while evaluating and managing patient health. These (E/M) codes have been around for many years still reporting timed-based services is confusing. So let’s […]
A patient portal is a website which offers patients convenient, 24 by 7 access to personal health information irrespective geographic location with an Internet connection. Patient portals have various features like patients can conveniently access appointment requests, get to know the authentic information about diseases, etc. This portals save patient’s time and encourage ongoing participation in […]
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