The Demands of Value-Based Reimbursement Model to Be Met With Medical Billing Specialists

With many of the healthcare reforms set to take effect shortly or having already been in force, providers may have entered a different phase of operational model, which is called value-based model. The unique feature of value-based model is that providers will get reimbursed for delivering superior medical care at a progressively lesser cost. As […]

Insurance Underpayments, the Issue That is Plaguing Orthopedic Billing the Most

Insurance underpayments continues to be a major concern for medical practices across the United States; more so for orthopedic surgeons, who, despite serving in a more critical specialty, find it hard to fully recover their medical cost. Because most of the orthopedic procedures happen to be highly expensive, even a marginal percentage of insurance underpayments […]

Orthopedic Billing Specialist to Take Care of CPT Code Changes Made to Orthopedic Surgery Billing in 2013

This year’s CPT Manual has spelt out extensive coding changes and revisions to orthopedic surgical codes. In all, there are 500 code changes to the Category I codes, including 251 revisions, 151 new codes and 100 deletions. Moreover, there has been significant overhauling of nerve conduction studies, some revisions to the radiology section, and E/M […]

Negotiating Your Reimbursement Rates during this Phase of Payer Consolidation & Health Insurer Monopoly Power

Physicians’ choice of health plans and contracts seem to be getting fewer and fewer with each passing moment as U.S. health insurance sector, particularly the private sector, witnesses unprecedented payer consolidation, acquisitions, and mergers amongst private health insurance carriers. Besides contradicting the hope that such consolidation, acquisitions, and mergers would bring down the cost premiums […]

How best are medical practices prepared to address HIPAA breaches?

Contrary to the notion that government’s move to digitize healthcare information would enable healthcare providers, doctors, and insurance companies comply more aptly with HIPAA’s guidelines for patients’ privacy and security, there has been an upsurge in HIPAA breaches with providers being reported for breaches of some kind or the other. Electronic Health Record (EHR) systems, […]

What Do Stage 2 Meaningful Use Guidelines Have in Store for Radiologists?

Stage 2 meaningful use guidelines are finally out, and radiologists may heave a sigh of relief since most of the ambiguity that existed in Stage 1 about their eligibility and the ways to approach the qualification criterion seem to have been made amply clear by CMS and the Office of the National Coordinator (ONC). The […]

Medicare Fraud Claims, A New Challenge Even For Honest US Physicians – is Competent Billing and Coding A Way Out?

In 2010, Medicare improper payment amounted to $47.9 billion. Human and Health Services, in 2011, recovered $4.1 billion paid through reimbursements as a result of ‘fraudulent’ or ‘improper’ claims. You may be right if you think you won’t ever be among the fraudulent care practitioners who contributed to these figures because you are scrupulous. But […]

Protect Your Medical Practice in Uncertain Times with a Medical Billing Specialist

The healthcare reforms brought by the Obama administration have in many ways been an industry-churning affair. They have changed the number of patients the healthcare centers receive today, affected the administrative activities that revolve around a typical treatment episode, shifted the professional location of several medical practitioners (independent physicians aligning with hospitals) etc. These changes […]

The Significance of HIPAA Compliant Medical Billing Services for Gastroenterologists

Gastroenterologists trade patient-centric information for a variety of purposes, and Medical Billing is one of them. While physicians clinical notes on gastroenterology procedures are made use of by coding and billing staff, there may be possibility, intentionally or accidentally, that vital patient-centric information being exposed to security and privacy breach in the form of theft […]

Demand for Gastroenterology Services to Impact Medical Billing in Clinics and Hospitals?

The consistent rise in demand for Gastroenterology services has really been a boon for clinics and hospitals. But the growth has been so overwhelming that it started affecting their reimbursements in a big way. While practitioners have generally been preoccupied with clinical duties, their medical billing staff have found the voluminous growth simply hard to […]

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