Are Medical Practices Moving Forward at the Same Pace as Healthcare Reforms?

Healthcare Reforms or Obamacare that had been facing a few political hurdles may have finally broken through all shackles and assumed greater acceleration. While healthcare reforms or Obamacare are largely perceived to pro-patient, physicians or medical practices have no option but to move with the requisite adaption. Amongst a host of reforms, the recommendation of […]

Billing Specialists to Look After Major Billing Issues Likely to Be Faced By Radiologists in 2013

Radiologists, who have been striving to maintain a balance between diagnostic priorities and operational compliance, may well find pulled further into a host of billing and compliance issues throughout 2013: To begin with, they will have to discern the vital connect between diagnosis coding and procedural coding systems and the systems that have evolved to […]

Efficient Billing Practice to Aid Physicians amidst Continual Coding Revisions, and Avert the Possibility of Denials

Amongst the possible reasons for denials, coding inadequacies seem to have a major impact. Because codes quantify and qualify physicians’ medical services for medical reimbursements from payers, any inherent coding error, miscoding, over or under-coding can lead to denials upon found to be incongruent with acceptable coding practices. While a few coding manipulations may happen […]

How Radiologists Can Refine Their Revenue Cycle Management (RCM) With Radiology Billing Specialists

The emphasis on Revenue Cycle Management could never have been so high as it is now – as radiologists begin to comply with of the Affordable Care Act’s (ACA) requirements, they would realize the importance of reinvent their billing and revenue cycle management process to suit the bundled care, shared risk, and quality-driven reimbursement models. […]

Responding To Growth-Induced Orthopedic Medical Billing Needs with Specialist Intervention

Orthopedics have been on upward growth trajectory thanks to a host of conducive factors – continued pro-orthopedic Medicare reimbursement reforms, innovative care procedures, breakthroughs in orthopedic technology and anesthesia administration have largely been responsible for upsurge in practice volumes. The combination of these factors has enabled shifting orthopedic from hospital-based inpatient form to a more […]

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, […]

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