The voluntary program Physician Quality Reporting System (PQRS) is meant to pay eligible professionals (EPs). This includes physicians under Medicare as well as a few select therapists and service providers who extend their services to beneficiaries under Medicare. However, there does exist a bit of confusion with medical practices on whether the requirements of PQRS […]
The medical practice has, and, is seeing a great many changes taking place in terms of healthcare reforms, the CMS rules & regulations with respect to reimbursements, and the ICD-10 coding system recently introduced in October 2015. These changes have affected a broad spectrum of both small, mid, and large healthcare providers specifically in terms […]
Physician credentialing or provider credentialing is a prolonged yet crucial procedure. Every physician who joins a new practice requires credentialing. It is a process of acknowledgment, attestation, and authentication of knowledge, proficiency, and motivation of the physician to provide medical care. If postponed for a long time or done arbitrarily, it can cause glitches in […]
EOB is an outcome of the claims process and is alternatively termed as a Beneficiary Notice, Summary of Benefits, Remittance Advisory, or Coverage Determination. EOB is NOT A BILL though it looks like one. It is simply an explanation of the claim covered/not covered by the healthcare insurers to the healthcare provider along with any […]
This is chiefly due to the number of hands the bill goes through; the count roughly being close to 300 people that are involved in the billing process at some stage(billing specialists, coders, medical practitioners, administrators, and insurance providers). There are numerous errors related to medical billing; patients are sometimes overcharged (charged for services not […]
With underpayments galore, and incentives that are not so very attractive, Medicare is proving to be adept at what it does best – lower the fees further with providers. Although the behemoth that Medicare turns out in its favor while bludgeoning down physicians’ fees, it may turn out to be its Achilles heel after all. […]
We are stepping into the New Year! 2015 has been a roller coaster ride with multiple healthcare changes that took place, the greatest of them being the implementation of ICD-10. Healthcare centers handled these changes pretty well, of course with effects that were pretty much visible. Striking a balance between the administration work and patient […]
Doctors, whose raison d’etre is to heal, actually end up focusing on loopholes in their billing process than focusing on tending the patients. Healing their patients and working towards healing the shortcomings of their billing process, resulting into denials is more of a balancing act. Most often there is a question as to why bills […]
One of the oldest medical specialties in the US is that of Otolaryngology. Medical practitioners in this area cure illnesses of the ear, nose, throat, and sometimes, the head and neck areas as well. This specialty encompasses the general and surgical treatment of among others, endoscopic sinus, allergy problems, sleep disorders, clinical audiology (usage of […]
Billing is the chief characteristic of any business. The same holds true for DMEs (Durable Medical Equipment); which denotes billing for the usage of medical equipment and supplies. DME includes wheelchairs, nebulizers, oxygen, traction equipment, walkers, kidney machines, crutches, ventilators, etc. DME is covered in certain illnesses under selected preconditions such as – if it […]
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