Towards Realizing Medical Data Integration Nationally

The benefits of Integrating Medical Data nationally can be far-reaching. Given its multi-applicability, Macro-level Medical Integration Of Data can enable enhanced medical service and cost-efficiency, privacy compliance as per HIPAA, transparent billing and coding as per CPT, ICD-9, & HCPCS procedures, ready availability of health data for numerous references and verifications, advanced clinical research with […]

Posted by Medical Billers and Coders July 26, 2011July 28, 2014EMR / EHR / Health IT, HIPAA / ACA / ACO, Medical Coding

Redefining the Role of Billers and Coders in the Wake of Ensuing Accountable Care Organization (ACO) Act

Amongst the many farsighted health reforms that the Patient Protection and Affordable Care Act of 2010 (PPACA) has floated is the concept of Accountable Care Organization (ACO). Believed to be a cost-controlling measure on public health expenditure, ACO is a health care model that ensures healthcare providers incentives from the savings made on a pre-assigned […]

Posted by Medical Billers and Coders July 25, 2011July 28, 2014Accounts Receivables, HIPAA / ACA / ACO

Negotiating Payer Contracts for Physicians

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 […]

Posted by Medical Billers and Coders July 21, 2011June 7, 2021Credentialing Services

Five Ways to Better Denial Management for Physicians

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 […]

Posted by Medical Billers and Coders July 19, 2011July 28, 2014Claims Denials

Practice management Software – Benefits for physicians

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 […]

Posted by Medical Billers and Coders July 19, 2011July 28, 2014EMR / EHR / Health IT

Payment Posting – Key to revenue cycle management

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 […]

Posted by Medical Billers and Coders July 19, 2011August 13, 2014Revenue Cycle Management (RCM)

The Changing Face of Denial Management

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 […]

Posted by Medical Billers and Coders July 15, 2011October 4, 2022Claims Denials

Fraud and Abuse: A major reason for waste in the US Healthcare Spending

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 […]

Posted by Medical Billers and Coders July 11, 2011July 28, 2014Healthcare Reforms

Increased inaccuracy in claims payments by health insurers

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 […]

Posted by Medical Billers and Coders July 11, 2011July 28, 2014Health Insurance, Insurance / Payer

Varying trends in physicians’ income in 2010

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 […]

Posted by Medical Billers and Coders July 11, 2011July 28, 2014Revenue Cycle Management (RCM)