Averting common operational & legal pitfalls at your medical practice

Medical practice and legal issues have long been inseparable. History is full of examples wherein practices have run into legal hassles, and eventually been penalized with criminal as well civil charges. Barring some strange cases that have been intentional, physicians have had to pay for what is known as negligence or reluctance to avail medico-legal […]

The Growing Shift from Private Practice to Hospital Employment

There seems to be something really interesting as far as the shift from private practice to hospital based employment recently: A consistent 2% annual decline in private practicing by physicians, which is expected to be at 5% annually by 2013 An upsurge in hospital employment accounting for nearly 51% of the physicians employed last year, […]

The Impact of Hospital Billing Processes on Patients’ Longer-Term Satisfaction

The way that business offices can have reference patterns amongst consumers is a tactical opportunity as the insurance market moves to high deductible plans and hospitals take in new physicians into their business. According to a survey conducted by Connance in 2011 Americans who received hospital services in the past 2 years, merely 21% of […]

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, […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]