Covid-19 affects the healthcare industry especially medical practices that experienced a negative financial impact directly or indirectly. For example- according to the Medical Group Management Association, there is a 60% decrease in patient volume since the beginning of COVID-19. Lockdown in the US forced patients to stay indoors due to which many patients delayed or canceled […]
It turns out that third-party medical billing can be extremely beneficial for medical practices because medical billing can take up a lot of valuable time. Moreover, it is difficult to find and train people to handle billing and coding complexities. Plus, if claims are processed slowly or incorrectly, they can negatively impact your practice’s revenue. […]
It is found that nearly 70% of Independent Physicians specialize in a certain aspect of healthcare and that the specialized nature of their practice within the local healthcare community enables them to remain independent. However, reimbursement of physicians working for a hospital or health system is significantly higher than that paid to independent physicians. According […]
Hospitals form an integral part of an ACO (i.e. Accountable Care Organizations), and hospitalists serve critical roles within their hospitals. Hence, they are very much interested in the impact of ACOs on their practices as ACO’s goals are a long list of hospital goals. In a patient-centered organization, the patient and providers are true partners […]
In today’s environment reimbursement continues to decline coupled with increased regulatory oversight hence it is necessary for physicians, patients, and the healthcare industry to be efficient. Hence Central Billing Office (CBO) is the answer as it improves efficiencies in billing, payment posting as well as enables enhanced customer service and seamless patient experience. Now let’s understand […]
To run independent medical billing practice becomes more complicated with every passing year. There are new regulations, coding updates (e.g. 2021 changes to E/M Coding), revisions in payer rules, and performance measures that can significantly impact your reimbursement. You need oversight of RCM experts to your revenue cycle, healthcare organizations cannot put their cash flow […]
The high level of spending on healthcare in the United States has been under increasing scrutiny for a long time. The realization that growth in health care spending in the US has outpaced growth in inflation, population, and GDP has intensified the concern of the federal government, providers, healthcare consumers, and payers. The lack of […]
Medical Credentialing is the process of requesting to participate in a health insurance provider network – or to be contracted with the insurer. Healthcare providers have to apply to and must be accepted by the insurance company. It is necessary to qualify for benefits and to be associated with or a “network provider” for that insurance carrier. […]
PECOS is the short form for Provider, Enrollment, Chain, and Ownership System. It is a database where doctors register with the Centers for Medicare and Medicaid Services (CMS). It is a national electronic database for recording and retaining data on Medicare-enrolled providers and suppliers. CMS developed PECOS as a mechanism to combat fraud and abuse. PECOS […]
As medical credentialing enables the patients to confidently trust their chosen healthcare providers, it has become very crucial. A medical practitioner cannot work at a hospital legally or partner with insurers, without proper medical credentialing. Only a new physician or practitioner who is credentialed is allowed to see patients, treat hospital inpatients, and receive insurance […]
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