Hospitals, in the US, are facing considerable challenges in the wake of innovative payment models. Innovative payment models are four different types of payment modules which apply to various phases of treatment episode and involve payment to the provider in the form of bundled payments. To understand how these models work, it would be helpful […]
Numerous US clinics profitability ratios have been depicting a downward trend and according to a recent physician survey, two thirds of the participants predict low profitability for the year ahead. This is not a positive scenario, and to change it first we have to consider the factors which are affecting the profitability of these clinics. […]
Hospitals, physicians and other care providers require being paid in a more systematic manner to help enhance quality of healthcare that too at a low cost. The current fee-for-service system in the US through which physicians are paid has been considered a major reason for escalating costs in the healthcare system. Under this system, physicians […]
Healthcare organizations need to ensure PHI (Protected health information) privacy if they want to avoid steep penalties. After the HIPAA Omnibus Final Rule was published in January this year, a final deadline has been set for practices to keep PHI secure and confidential. In case healthcare providers fail to comply with the new requirements, the […]
In the last five to ten years reimbursement for medical practices has been impacted by various changes in the healthcare industry. These changes include HIPPA tightening their requirements for data submission, upcoming ICD-10 final implementation date coming closer, amongst various others- which have a direct impact on medical documentation and hence on the medical practice’s […]
Streamlined Internal Medicine Billing Process Many internal medicine practices in the US face the challenge of a shrinking bottom line, mainly due to the diverse aspects of the specialty—diagnostic, preventive, and curative. Due to this collaborative nature, the internal medicine billing process is particularly complex, where treatment episodes often involve coordination with various diagnostic laboratories […]
The Healthcare Insurance Portability and Accountability Act of 1996 – protects the confidentiality of the patients’ electronic medical health records from unauthorized access. This makes it crucial for health care providers to be cautious while considering with whom to share patient information; along with bringing upon added responsibility on the medical practice and its staff. […]
Challenges faced by practices today Medical claim denials are very frequent; due to computer technologies that detect the slightest of errors and immediately reject such claims. The reasons for rejection can range from registration inaccuracies, invalid diagnosis code to lack of authorization and common insurance glitches such as ineligibility for insurance, maybe a case of […]
Cost of healthcare in America has shot up due to the way healthcare providers are being paid for their services under the fee-for-service system, which has bought about an urgent need for health care payment reforms. However with the introduction of various new payment models; a medical practice needs to expand its capabilities to appropriately […]
Cash flow for a practice greatly depends on timely follow ups with insurance companies and reimbursements. Only when you manage medical billing and coding effectively, you will be able to handle your revenue cycle and account receivables. How much has changed due to healthcare reforms? Even though responsibilities and goals have remained same after implementation […]
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