Over the last few years, the healthcare system in the United States has witnessed modifications in policies and regulations, in order to make healthcare facilities cost-effective and accessible to people from all income groups. However, a substantial percentage of the population still remains uninsured and the introduction of the Patient Protection & Affordable Care Act […]
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Denial Management – Integral to Physicians’ Conquering Reimbursement Challenges While Medical Billing
Denials are responsible for major erosion of practice revenues, and, despite the best efforts, denials continue to assume monstrous proportions. The situation has grown so alarming that: Medical practices fail to collect 25% of the money they are owed $125 billion is left in the bag as unpaid claims Only 70% of claims are paid […]
How can A Medical Billing Service Help in Increasing Revenue at Your Practice?
Quality and cost have been inseparable. And, as U.S. health care industry is defined by new quality benchmarks, cost of administering medical services too seems be rising proportionately. While physicians continue to respond with appreciable clinical efficiency, they seem to have lost ways to find sustainable existence and growth. The existence of intense competition has […]
Monitoring Potential for Up-Coding Errors in EHR with the Help of a Medical Billing Service
There has been considerable resolve and persuasion from the Federal Government to introduce Electronic Health Record System across the health care continuum. The Health Information Technology for Economic and Clinical Health (HITECH) Act has indeed given much impetus to pace of conversion from paper to electronic medium. The bait of financial incentives and penalties for […]
Combining Medical Billing and Coding to Deliver Maximum Physician Revenue
‘Medical billing’ and ‘Medical coding’ may have sometimes been used interchangeably to mean the act of claiming reimbursement from insurance payers, but essentially they are two separate and specialized jobs. Medical coding precedes medical billing, and it is irreversible. While a medical biller is entrusted with far more task than a coder, it is the […]
Medical Practices Anxious About the Impact of ICD-10 Transition
While the recent one year extension (from October 1, 2013 to October 1, 2014) in deadline by the U.S. Department of Health and Human Services (HHS) may somewhat have eased the pressure, yet the anxiety still persists among the majority of medical practices in the US. The “anxiety” is about the impact of ICD-10 transition […]
Navigating through Regulatory Changes that Dramatically Affect Medical Billing
The limited reach of US healthcare network leaves a large part of American population outside the net of healthcare. This problem has stalked US governments traditionally and to expand the reach of healthcare to make healthcare available to a larger part of US population, successive governments (in varying degrees and as suited their political beliefs) […]
Increasing Revenue through HIPAA Compliant Practices
HIPAA (Health Insurance Portability and Accountability Act), which was first enacted in 1996 to improve the efficiency of healthcare delivery, has come to be recognized as the standard for electronic data interchange (EDI), security, and confidentiality of all healthcare-related data. The Act mandates: standardized formats for all patient health, administrative, and financial data; unique identifiers […]
Billing “Urgent Care” As It Emerges As One of the Fastest Growing Specialties
Urgent care is fast developing as a viable alternative to what has traditionally been known as “family practice”. The main reason behind this new-found fancy is that physicians can now operate from designated facilities without having to trek around offices, nursing homes, and hospitals. Additionally, urgent care centers are preferred to other similar types of […]
Navigating Through a Multiple Payer Environment – Providers’ Perspective
Healthcare delivery in the United States of America has come a long way from cash-based to insurance-backed. Currently, over 85% of the nation’s residents have health care plans either through employers’ private pools, private companies, the veterans’ health administration, the children’s health insurance program and Medicare/Medicaid/TRICARE. While insurance payers (whether Federal or private) essentially cover […]