Hospital Billing and the Ghost of Imminent Medicare-cut Impact

Hospital billing serves the role of invoicing for the medical services delivered by hospitals or healthcare organizations, both for in-patient and out-patient care. Hospitals, which hitherto could evade the backlash of the Sustainable Growth Rate (SGR) fix, face an imminent 27.4% reduction to their Medicare fees starting this January unless the Federal Government decides otherwise. […]

Is Accountable Care Organization (ACO) Model Viable?

“Given the situation, although the Accountable Care Organization (ACO) model of medical care seems a safer option, yet the initial clinical & operational realignments and adhering to CMS compliance measures may seem a bit exhausting for physicians. But, sooner or later, ACO can become mandatory requiring radical realignments amongst practitioners. Therefore, rather being forced into […]

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 […]

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 […]

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 […]

Revenue Cycle Management – Prescription for Optimum Medical Claim Realization

“Despite such volatile environment, physicians have to find means to realize their each and every dollar owed them as their very sustenance and growth hinges on efficient reimbursement of medical bills” Unlike other professional services that realize their professional fees instantly, without having to rely on a third party (insurance carriers), physicians have to go […]

U.S. Health Spending Projected To Grow at 5.8 Percent Annually: Pros and Cons

The recent extrapolation by the economists in the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS) – which has projected all health care spending in the United States to be at an annual average rate of 5.8% for the period 2010 through 2020, and at 19.8 percent of GDP by […]

Better Revenue Cycle Management For Physicians with Skilled Billers and Coders

Accurate revenue cycle management means you get paid in a timely manner and that the accounts receivable balance is zero when the cycle is complete. However, this type of management could become cumbersome for physicians, as it is not their primary occupation, and the recent health care reforms would mean more patients and greater work […]

Primary Healthcare: A Critical Reassessment in the Changing Healthcare Scenario

The Primary Health Care (PHC) system in the US has so far served as a platform for providing frontline care with services provided by medical professionals ranging from family physicians and assistants, internal medicine specialists, nursing practitioners, and clinicians. In this blog we will discuss about, Primary Healthcare: a critical reassessment in the changing healthcare […]

Effective Patient Care versus Revenue Cycle Management: Physicians Perform a Balancing Act

Physicians in the U.S., despite ranking high for their medical competence, have never been able to fully realize and optimize their medical bill reimbursements owing to an increasingly complex health insurance system that has been constantly evolving, and characterized by: HIPAA Compliant Medical Reporting Stringent Billing and Coding Regimen Technological Interface for Electronic Billing and […]

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