Understanding External Payer Audits An external payer audit is an examination of a healthcare practice’s finances or processes conducted at the will of payers. These payers are either the government or a commercial insurance company looking to ensure correct payments were provided to the practices for past cases. Government audits can be broken down even […]
The medical audit is the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources, and the resulting outcome and quality of life for the patient’.The audit is a continuous cycle involving observing practice, setting standards, comparing practice with standards, implementing change, and observing […]
Prior authorization is a check run by some insurance companies or third-party payers before they will agree to cover certain prescribed medications or medical procedures. There are a number of reasons that insurance providers require prior authorization, including age, medical necessity, the availability of a generic alternative, or checking for drug interactions. A failed authorization […]
The first thing any patient comes and sees in your office is the front desk. They have a simple superpower to make your practice profitable and i.e. through patient scheduling. Your Front desk ensures that all your patients coming to the practice see a smooth flowing schedule and get the required customer service. Your front […]
Patient Engagement is an invitation for participation with shared decision-making and to create a take on aspects of communication-channels which will provide the patients the benefit of managing their own health under the care of physicians or with the member of the healthcare team. An activated or engaged patient will provide the healthcare system with […]
The voluntary program Physician Quality Reporting System (PQRS) is meant to pay eligible professionals (EPs). This includes physicians under Medicare as well as a few select therapists and service providers who extend their services to beneficiaries under Medicare. However, there does exist a bit of confusion with medical practices on whether the requirements of PQRS […]
There have been rapid strides in the development of technology and we use it in most spheres today. Medical practice has benefitted immensely through technology, enabling patients to gain access to quality healthcare. However, Cybercrime too has become highly sophisticated and combating phishing, hacking, and other such activities is indeed a challenge. How secure is […]
Hospitals are big centers where paper-based prescriptions are largely used and where a lot of time is spent on resolving issues with the pharmacies regarding errors in handwritten prescriptions. E-prescribing is the electronic method of generation, transmission, and filling of a prescription, replacing paper prescriptions. Continuous efforts of the US towards enhancing the quality of […]
There have been a number of changes related to medical billing this year. Many professionals will report that these changes are because of Obama Care. Others may even state that the ICD-10 changes have created these changes. While these changes may be easy for some, it is always important to remember that changes can create […]
The new health care Reforms in the shape of the popularly known Obamacare or Affordable Care Act has met with great resistance from many physicians. Pro or against the many reforms that this Act has brought in, changes in the way physicians practice medicine will be undergoing change- positively or grudgingly. However, any Act that […]
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