Physician Credentialing: Worth Getting Right to Get Paid

Physician Credentialing Physician credentialing is the process of organizing and verifying the professional records that qualify a doctor to practice medicine. As physicians, despite your reputation for benchmarked medical services, you could be losing out when it comes to realizing medical bills reimbursed fully by respective health insurance carriers. And when you start to analyze […]

Paid-Sick-Days Concept as a Preventive Option for Federal Healthcare Expenditure

“Coming at a time when Federal Government itself is promulgating radical healthcare reforms to tackle growing medical expenditure on public healthcare, and promote efficient and quality medical care to its ever growing insured population, this paid-sick-days concept promises to complement the macro healthcare reforms formulated by the Federal Health Department.” Strange it might seem, yet […]

Doctors Contemplate Opting Out Due to Continued Medicare Hassles

Physician participating in the Medicare program are scheduled to face a 27.4% cut in their payments, effective 1st January, 2012, and with providers anyway complaining about current reimbursement rates, the cut is likely to considerably impact both patients as well as doctors adversely. As a result of the cut the Medicare physician conversion factor will […]

Revenue Cycle Improvements for Physicians and Clinics: An Overview

The revenue cycle management process starts even before the patient visits a physician’s office or a clinic or hospital and ends when full reimbursement is realized. The scope for improvements in the revenue cycle management process has been accentuated in the recent times due to changes in the health care industry and the health policies […]

Radiology: Finding New Meaning in “Meaningful Use”

Radiologists in the United States are currently facing a dilemma as far as “meaningful use” (MU) of Electronic Health Records (EHRs) is concerned. The American College of Radiology (ACR) IT and Informatics Committee leaders and staff have met the National Coordinator for HIT (ONC) as well as Center for Medicare and Medicaid Services (CMS) staff […]

single payer system vermont

Vermont: State with Single payer system “Single-payer health system” which was passed in May 2011 by the Vermont governor, expects to accumulate savings of 24.3% of total health expenditure between 2015 and 2024, according to Harvard economist William Hsiao. Vermont is to be the first state in USA to implement this system, which will move […]

Dealing with overpayments in your practice

“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 […]

Standards of Ethical Medical Coding: Part 3

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 […]

Mastering the Reimbursement Battle Against Payers

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 […]

Evaluating the Procedural Constituents of Medical Claim Management Cycle

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 […]

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