Exodus to Hospital-Based Employment and its Effect on Healthcare Industry

While the recent healthcare reforms ushered in by the Federal Government promises to elevate clinical and operational efficiency across the nation’s healthcare continuum, it is also going to induce physicians into a more accountable and responsible quality clinical regime. The imminent Accountable Care Organization Model, Medicare cuts, the fear of Sustainable Growth Rate (SGR) backlash, […]

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The Changing Face of Primary Care: An Overview

The shortage of PCPs in the United States has been a well-publicized and well-documented issue. However, the solutions to the various issues faced by primary care in the country have been obscure even after the implementation of the Affordable Care Act. The complications in finding the solutions to the challenges faced by primary care stem […]

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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 […]

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The Financial Importance of Timely Medical Claim Submission

The importance of timely claims submission is not lost on physicians or their staff and is an integral part of the revenue cycle management (RCM). The dynamic nature of the health industry and the reforms has further exacerbated the already volatile situation when it comes to claim submission, denials, and re-submissions. There are numerous factors […]

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Predicting the Scope of Medical Billing Consultants after 2014 and beyond

Although it has been quite a while since the Federal Government announced a series of far-reaching healthcare reforms, we are yet to experience their full impact across the healthcare continuum. And, with the Senate bill deferring a major chunk of the reforms further, it is expected that we may have to wait as late as […]

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Physicians tackle HIPAA Requirements and Increased Scrutiny by Government

The health reforms have not only affected the way in which healthcare is delivered but also the way in which information is shared among various professionals and entities in the health industry. Health Insurance Portability and Accountability Act (HIPAA) regulations have become more stringent for physicians, and patient privacy is one of the issues that […]

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Hospitals Expand to Attract Well-Insured Patients Despite Pressures of Healthcare Reforms

Several hospitals are looking for well-insured patients beyond traditional market boundaries, both in prosperous suburbs and in nearby areas with growing, well-insured populations. According to a study by the Center for Studying Health System Change (HSC) hospitals seeking a competitive edge in the marketplace are targeting geographic expansion into new markets which are well-insured. The […]

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HIPAA 5010 enforcement delayed to ensure doctors & entities complete transition

Enforcement of HIPAA 5010 transactions on March 15, 2012, was delayed for the second time for another 3 months by the government, with the Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services (OESS) pushing the date further to June 30, 2012, in order to not compromise physician cash flow. Physicians have […]

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How are States Retaining Physicians in Times of Shortage?

Physician shortages is a growing concern and is pushing various states to keep doctors trained in medical schools and residency programs from crossing state lines to practice medicine. According to new statistics from the Assn. of American Medical Colleges- nationwide, there were 258.7 active physicians per 100,000 people and in individual states, ratios range from […]

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Electronic Health Records Spurring Hiring of Staff Besides Adding to Costs at Physicians Practice

Electronic Health Records (EHRs) are complex systems and a dedicated team of professionals are required for handling and maintaining these systems for smooth operation of such records. The drawbacks of paper based records, the projected advantages of EHRs, and the incentives offered along with the penalties for non-adoption of EHRs are driving hospitals and small […]

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