The importance of negotiating or renegotiating payer contracts has drastically grown after the recent health care reforms. This is because insurance companies are being reined in by the government and may see a decline in profits. This presents a good opportunity for payer contracts to become a source of income more for the insurance companies […]
Denial management is one of the crucial aspects for a physician and can assist in improving the revenue cycle management. This can not only reduce errors while managing claim denials but also help in increasing the physician’s revenue. This process is carried out by medical billers and coders who have specialized knowledge in the field […]
Practice Management Software (PMS) can be a powerful tool for physicians since it can optimize administrative and financial activities in order to directly increase revenue and save time. A flexible and efficient PMS allows billers and coders to view Remittance Advice Reports and Claim Payment Reports in addition to interpreting Electronic Remittance Advice from the […]
Payment posting is one of the most important steps that can assist in improving a physician’s revenue if done efficiently. Although payment posting is becoming electronic and automated there is still the need for checking for accuracy and errors in the posting. There are numerous ways in which physicians can benefit from accurate and efficient […]
Denial management is one of the aspects that affect physicians, health care providers, insurance providers, and patients alike. The major problems faced by billers and coders along with patients are that the insurance companies or payers deny claims based on any reason they can find. This includes technicalities and some aspects such as pre-existing conditions […]
Health care fraud and abuse is an important and conspicuous factor in the resource and finance drain in the US healthcare system and is responsible, to an extent, for the escalating healthcare costs. According to a report by Thomson Reuters on US healthcare spending, the US healthcare system wastes between $505 billion and $850 billion […]
Commercial health insurance has registered an increase of 2% over the existing average claims processing error rate of 19.3%. This 2% translates to an extra 3.6 million in erroneous claim payments, and costs an additional estimated $1.5 billion in highly avoidable administrative costs to the health system. AMA (American Medical Association) has released its Fourth […]
2010 registered a positive trend in terms of increased income for primary care physicians in the US. The increase in income varies according to the specialties i.e. some specialties saw a modest increase in income while others saw a more pertinent rise. The factors which are responsible for these changes in the income vary from […]
Adhering to the HIPAA 4010 compliance has been a long-standing ordeal for medical billing and coding professionals and now, on January 1, 2012, the electronic healthcare transactions standards change from version 4010/4010A to version 5010 will definitely need a closer look at the compliance guidelines. The healthcare industry and professionals need to thoroughly acquaint themselves […]
Recently, Texas has lifted a ban on prohibiting rural hospitals from employing physicians in order to solve the problem of shortages of doctors and health care providers in states such as Texas and California. However, it remains to be seen whether the recent healthcare reform would have some positive impact on the remuneration of physicians […]