‘The readily available sources for implementing security-rich technology platforms should not only make your search easier but also ensure Patient Privacy Compliance by sage-guarding critical information against undesirable proliferation, and sharing information only at the behest of patients’ Although there have been sporadic incidents of patient privacy breach, yet, the recent episode reported in a […]
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Combating Healthcare Fraud and Abuse – A Challenging Task for Providers
The inherent nature of Health Insurance is such that it is highly susceptible to fraud and abuse by unscrupulous healthcare providers and beneficiaries. Consequently, there has been an unbridled rate of fraud and abuse amounting to billions of dollars – a reliable statistics puts it around 300 billion dollars, and still counting. Whereas, primarily, it […]
Small Practices: Adapting to the Challenges of Healthcare Reforms for Better Revenue
The major challenges faced by physicians who run a small practice or clinics that have less than four or five physicians are expanding exponentially. Many physicians find themselves worrying and spending time on administrative processes and interacting with payers rather than spending some quality time with their patients. The recent health reforms including the HITECH […]
Standards of Ethical Medical coding: Part 1
Coding is one of the core functions of healthcare providers and, due to the complex regulatory requirements impinging upon the health information coding process, coding professionals are frequently faced with ethical challenges. There are stringent medical Billing guidelines in place for the entire gamut of coding practices which include issues such as the privacy of […]
CPT Category II Code Updates by AMA
The American Medical Association (AMA) has released an update of CPT Category II code list, which will first appear in CPT 2012, with an implementation date of 1st Jan, 2011. The CPT Category II codes are supplemental tracking codes that can be used for performance measurement. The use of tracking codes for performance measurement will […]
Increasing Demand for Certified Coders in Healthcare
The year 2010 has set a premium on the coding professionals, registering a rise in their average salaries. And as expected, the salaries for certified medical coders are higher as compared to the non certified ones. According to a salary survey of nearly 12000 coding professionals, the average salaries for credentialed coding professionals have increased […]
Decoding Common Billing Blunders & Devising Ways To Quell Them
The growing incidence of delays, denials, audits, and resubmission of physicians’ medical bill claims is reason enough to have a relook at the way physicians’ services are billed and coded. In a medical insurance environment, characterized by stringent billing and coding compliance, inherent billing and coding errors are easy to catch. Further, lack of knowledge […]
Superbill Analysis – An Imperial Stamp of Authentication
“Consequently, physicians’ medical bills get an imperial stamp of authenticity, and nullify the chances of undesirable delay, denial, resubmission, and audits from highly stringent medical insurance companies” Notwithstanding physicians’ integrity in preparing honest Superbills, comprehensive analysis has become imperative before these can be submitted to payers for reimbursement because of the highly dynamic nature of […]
Sustainable Physician Practices: A Judicious Mix of Human Resources and IT
While physicians’ competence will forever remain pivotal to excellence in patient care, the auxiliary services – on duty nurses, para-medical staff, and administrative staff – which ease the load off physicians are equally crucial. There are ample instances, wherein, despite best efforts of physicians, healthcare services have been found well short of bench-marked quality, largely […]
Patient Engagement Model: Enhancing Patient Care & Revenue Through IT
Notwithstanding best quality of medical care offered by individual physicians, clinics, hospitals, and multispecialty groups across the US, there has been an interesting debate – how to leverage digital technology in pushing the prevailing medical care standard to the next rung while also optimizing revenue in the process. Whereas Patient Engagement Model is not a […]