“Simple it might seem, yet given the time and the resources that such monitoring and reporting eventually consumes, physician practices can find it hard to take up such intensive scrutiny amidst the overriding challenge of keeping their medical service quality benchmarked to the perennially raising medical standards. All such apprehensions point towards outsourcing medical billing […]
Chiropractic Physicians in the US: A Brief Analysis and Outlook Chiropractors in the United States currently face numerous challenges and the recent health reforms have made a profound impact on this occupation. Moreover, the competition that it faces from other alternative medicinal specialties such as acupuncture, physical therapy, and massage therapists has brought forward many […]
Contrary to mounting demand, US healthcare industry continues to be plagued by shortage of dermatologists – the physician-patient ratio has grown to be so unhealthy that patients have to wait as long as 38 days just to have an appointment with their physicians; there have even been extreme cases of waiting being stretched to 73 […]
Healthcare Insurance industry requires stringent guidelines and ethical practices for the protection of patient information. The field of medical coding and billing falls under the same ethical guidelines as any other part of the medical industry. Coding is one of the core functions, and due to the complex regulatory requirements affecting the health information coding […]
Physicians are likely to face another cut in Medicare reimbursements of 27% in 2012, in a scenario where doctors state that insurers regularly underpay or flat out deny, as a matter of course, legitimate health insurance claims worth billions of dollars each year. According to American Association for Justice (AAJ) the US insurance industry is […]
Center of Medicare and Medicaid announced that it will delay enforcing HIPAA 5010 transaction sets requiring hospitals, physician practices, health plans and claims clearinghouses to switch to using the ASC X12 Version 5010 standards for the electronic transmission of healthcare claims and other administrative communications until March 31, 2012 instead on Jan 1,2012 as originally […]
Given the alarming statistics about medical billing industry average – 14% of all claims submitted to the payers are denied and have to be resubmitted, appealed or written off by providers, 50% of denied claims are never re-filed, and 50-70% of denied claims have higher chance of being recovered – physicians’ reasoning seems to be […]
Unlike physician practices of yesteryear’s, physician practices today have found themselves surrounded by a larger pool of stakeholders: patients, government, and insurance carriers. While physicians commitment to quality medical services continues to be unquestionable, their ability to comply with escalating government’s healthcare norms, and insurance providers’ stringent reimbursement policy has been found wanting. As the […]
The Center for Medicare and Medicaid services is poised to take bigger steps in preventing fraud and abuse by increasing its monitoring and analytics capabilities. CMS will conduct enrollment and medical claims analytics to keep frauds out of Medicare, for this some necessary technology is already deployed, while the other systems will be ready by […]
Center of Medicare and Medicaid services released the final accountable care organization rule. ACO’s consist of physicians, hospitals, and other providers in various combinations that attempt to coordinate the care of Medicare patients with the goal of improving its quality while reducing costs. Successful ACOs would be entitled to share any savings they produce for […]
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