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 […]
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 […]
While physicians and health insurance providers have been indispensable and integral to US healthcare industry, the trust with each other has not been all that convincing – physicians being apprehensive of growing rate of denial and delay of their patients’ health insurance claims, and health insurance carriers being suspicious of physicians’ integrity in medical billing. […]
The proposed Medicare cuts by President Obama and the Congressional “Super Committee” does not bode well for physicians and geriatric medicine in the country. Although the cuts would ensure that Medicare bankruptcy would be postponed and the Federal deficit reduced, it has long term negative consequences for long-term care hospitals, nursing homes, home health facilities, […]
Appealing denied claims is one of the important steps in enhancing the revenue of physicians and this fact is supported by a report by the U.S Government Accountability office (GAO). The report released on March 16, 2011 states that – “coverage denials occurred for a variety of reasons, frequently for billing errors, such as duplicate […]
The tax exemptions for physicians serving in underserved areas are no longer limited to a few states and have expanded to the whole nation, according to the IRS. The Affordable Care Act makes provision for professionals who received student loan relief under state programs that reward those who work in underserved communities may qualify for […]
“The prevalence of such demanding challenges is reason enough to push physicians beyond their Medical Billing Management capabilities, which invariably results in compromised medical efficiency. Therefore, physicians – faced with insurmountable challenges of inpatient medical billing management – have either to set up a dedicated team in-house or look elsewhere for competent outsourced solutions.” Unlike […]
Despite vigilant system of medical claim submission practiced by physicians, the recent statistics released by the American Medical Association (AMA), has reported an increase in medical billing inaccuracies by 2% over the last year’s results. What is more significant is – apart from delay or denial owing to inherent error-prone claim submission – the estimated […]
The overlapping nature of certain medical procedures is such that it is impossible to report them with CPT codes alone. Although CPT coding has grown to be comprehensive enough to cover breakthrough procedures over the years, yet, physicians are not spared from submitting separate procedural forms for medical procedures requiring explanation that overshoot the CPT […]
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