‘Pay-as-you-go’ as a value-based medical billing service model

While we are not alien to the term ‘pay-as-you-go’, it is something that is catching the imagination of physicians opting for outsourced medical billing services. Unlike in the past, when ‘pay-as-you-go’ was sporadically availed by a few physicians, it is now emerging as a viable alternative to long-term contractual medical billing services. Well… what is […]

Posted by Medical Billers and Coders June 13, 2012July 28, 2014HIPAA / ACA / ACO, Payment Models

The Growing Emphasis on Medicare-Specific Medical Billing Services

Medicare, which continues to remain as the nation’s largest public health insurance scheme covering nearly half the United States’ population in its health insurance ambit, has gone through considerable reforms over the years. In fact, the evolution of Medicare can be defined as: Phase-I when it actually used to reimburse physicians the actual cost of […]

Posted by Medical Billers and Coders June 12, 2012July 28, 2014Payment Models

Is Medicare and Medicaid Reimbursements fairer than Private Insurers: a Brief Comparison

Various providers despite being paid lesser by government than by commercial insurers believe that Medicare and Medicaid reimburse more fairly than commercial payers. Findings from a recent survey depicted that 93% of respondents feel that Medicare is fair always or frequently while 62% felt the same about Medicaid, whereas 62% were of the view that […]

Posted by Medical Billers and Coders May 11, 2012August 13, 2014Payment Models

Effects on Physicians Reimbursements: Insurance Denials and Uncertainty of Health Reforms

Insurance denials are one of the major factors that affect a physician’s revenue even though health reforms do address some issues faced by patients and physicians in dealing with insurance companies, the denial rate of claims has not significantly altered due to such reforms. These insurance denials are avoidable especially as they create problems for […]

Posted by Medical Billers and Coders May 4, 2012August 13, 2014Payment Models

Measuring the Impact on Physician Reimbursements With Upsurge in Retail Clinics

“As medical service providers try to adapt themselves to these altering equations, their ability to manage clinical and operational functions would invariably involve the next level of efficiency. While there is ample scope for revenue augmentation amidst a booming health insurance scenario, there is also the issue of keeping the quality of medical services on […]

Posted by Medical Billers and Coders March 12, 2012August 14, 2014Payment Models

Physician Bundle Payment Plans: Improving Claims Generation

Healthcare is costly in general and what makes it more prone to increase in costs is that it comes in phases: pre-hospitalization, hospitalization and post-hospitalization. To address the situation and provide patients with an all-encompassing payment package, many payment modules have been tried out over the years across all states of the US. But the […]

Posted by Medical Billers and Coders February 7, 2012June 15, 2023Payment Models

Upfront Realization as the catalyst for accelerating Physician reimbursement

“As physicians juggle with their core medical focus and issues related Upfront Collections, there would eventually be an adverse impact on their ability to afford quality medical care. Therefore, sooner or later, they would have to decide on outsourcing the competent services that can offer the best upfront Collection as part of the comprehensive Revenue […]

Posted by Medical Billers and Coders February 3, 2012July 28, 2014Payment Models, Revenue Cycle Management (RCM)

Deciphering Medicare Fee Schedules

A proactive affinity to Medicare Fee Schedule alerts physicians to the efficacy of attending to Medicare beneficiaries, and also plans their revenue prospects in advance. But, with the legislation firm on mandatory medical service to Medicare patients, physicians are inevitably driven to seek and understand Medicare Fee Schedule. The sheer volume of Medicare transactions (more […]

Posted by Medical Billers and Coders October 18, 2011July 28, 2014Payment Models

Bundled payment initiative to lower healthcare costs, help coordinate care

A new program to aid and improve patient care while patients are in the hospital and after they are discharged has been announced by the U.S. department of Health and Human Services (HHS). These initiatives will also motivate doctors, nurses and specialist to perform coordinated care and hence reduce cost. Till date, hospitals, physicians, and […]

Posted by Medical Billers and Coders September 7, 2011July 28, 2014Payment Models

Impact of Federal Debt Ceiling on Medicare Payments to Physicians

Debt ceiling on Federal Debt is a perennial topic for debate in the US healthcare scenario. Debt ceiling or Debt limit is the brink to which U.S. Federal Government can raise debts to fund its budgetary allocation. Although there have been instances in the past that allowed for raising debts well over the statutory limit, […]

Posted by Medical Billers and Coders August 30, 2011August 14, 2014Payment Models