With healthcare being linked to insurance in most cases, it is important to verify eligibility to ensure lower denials. At the pace with which administrative procedures are executed in healthcare, it is highly possible that incorrect or insufficient information is updated during billing. This results in a tedious and entirely avoidable process of denials and delays in clearance of claims. We take a closer look at the benefits of proper insurance eligibility verification in medical practice. Continue reading “How Insurance Eligibility Verification Helps Medical Practices”
Everything You Need to Know About Physician Credentialing
Utilizing the services of medical professionals with the right credentials lends confidence to patients. Beset with reports of poor medical intervention and rejected insurance claims, it is important to choose the best physician. Physician credentialing helps patients and payers of patients’ bills alike through the review of various parameters of physician competency. This concept of enrolment is explained in brief below, which will give a fair understanding of the process and its benefits.
Learn more about physician qualification and by extension, competency
The qualification of a physician can, to a certain extent is indicative of competency. Physician credentialing involves the collation of information pertaining to completion of training by the doctor and subsequent board certification. This is then followed up with verification on the authorization granted to the physician to prescribe medications. Continue reading “Everything You Need to Know About Physician Credentialing”
How an effective WFM tool can save millions of dollars of AR in Medical Billing
Changing Payment Methods:
At this time of US healthcare evolving into different payment methods and moving from traditional Fee for Service payments, it is important for billing companies to ensure that their end clients get paid all their claims either by insurance payments or patients to maximize their revenue and reduce write off of unpaid claims due to passing appeal limit and timely filing limits.
On the other hand, Billing companies also need to ensure that every claim is paid the correct amount as per the Fee Schedule, Contracted rate, UCR etc. and are not underpaid. Underpayments and failure to appeal on underpayments cause significant revenue loss to providers.
In order to achieve the above, a very strong Accounts Continue reading “How an effective WFM tool can save millions of dollars of AR in Medical Billing”
Medicare Revalidation process for Providers and Suppliers
CMS has defined time frame for providers and suppliers to send their re-validation application to the Medicare Administrative Contractors (MAC) to be in compliance with provider enrollment requirements. The due dates generally fall on the last day of the month, for example, 30th June, 31st July which is determined based on the last successful re-validation or initial enrollment date. Continue reading “Medicare Revalidation process for Providers and Suppliers”
How does Health Insurance Impact your Tax this Year?
The ’Individual Mandate’, one of the Affordable Care Act reforms, has been the hot topic in the US healthcare space lately. This policy has made buying health insurance mandatory for those people who are uninsured. The ultimate goal of this policy is to promote a healthier nation; however there is downside to it. Continue reading “How does Health Insurance Impact your Tax this Year?”
Preventative Healthcare Gets Its Importance In Obamacare
‘Prevention is better than cure’ – Recognizing the truth in this adage, ‘Obamacare’ has brought in the preventative healthcare services to create a healthy tomorrow. Heart disease, stroke, cancer, chronic low respiratory disease and accidental injuries are considered as the five main causes for the increased mortality rate in the US. Continue reading “Preventative Healthcare Gets Its Importance In Obamacare”
CMS’ Health Surveys to strengthen PQRS
Consumer Assessment of Healthcare Providers and Systems:
This is a survey developed by CMS, to gain feedback from patients and their relatives about experiences with and ratings of their healthcare providers and plans. The survey includes hospitals, home health agencies, Doctors (single and groups), and health drug plans. The survey results are publicly shared by CMS, so Providers may have an impact due to ratings, because it is the feedback of the patients. Continue reading “CMS’ Health Surveys to strengthen PQRS”
Ebola Scare in the US!
The growing panic among the US citizens over the Ebola virus has become the recent buzz in the country. The US Centers for Disease Control and Prevention (CDC, Atlanta) has estimated that by August 2014, approximately 68 Ebola scares were handled by US healthcare facilities and state labs. The numbers have doubled and tripled in the months of September and October. The latest news is that the deadly virus could reach Britain and France by the end of this month (October). The approximate number of people infected so far by this rapidly spreading virus is 7,200. Let us take a look at when and where it all started and how scientists and healthcare workers are struggling to contain a full-fledged outbreak: Continue reading “Ebola Scare in the US!”
Why is India a Better Offshore Destination?
Lately, outsourcing medical billing has become a common practice in the US healthcare domain. To streamline the medical billing activities of a customer, US medical billing companies partner with offshore medical billing companies located in various countries, including India. Continue reading “Why is India a Better Offshore Destination?”
It is Insurance Eligibility Verification time!
The effort taken by most healthcare entities in minimizing claim denials has become remarkable in the recent times. They pay more attention in documenting patient demographics, entering ICD & CPT codes, updating current charges, performing regular AR follow-up and more. However, their claims still get denied by the Payer. Continue reading “It is Insurance Eligibility Verification time!”