Medical Billing & Credentialing News

  Healthcare Practice Revenue Affected by Medical Billing Issues Let’s say a patient comes in and gives you his or her Medicare card. The front desk carefully records the information and billing submits the charge to Medicare.  But the claim is rejected, maybe even from the clearinghouse. The problem? The patient thinks he’s simply on Medicare, but his plan is actually with Blue Cross, United Health Care or another Medicare Advantage plan. This is but one example of a billing error As a healthcare provider or medical facility, you want to provide the best possible medical solutions, determining the right diagnosis and treatment plan for your patients. But, you also must manage the costs of running your health facility. However, are you aware that medical billing issues can impact your practice revenue? Running a cost-effective, efficient medical practice demands a consistent and reliable revenue stream. Unfortunately, that’s going to be difficult to achieve if your billin...

  Patient Flow Increases Revenues No longer can  healthcare practices  rely on the single appointment and waiting room process. Managers of healthcare practices of all types and sizes increasingly recognize that effective patient flow is key to increasing revenue and improving efficiency for the practice as well as providing a positive experience for the patient. As the business manager of a fast-growing orthopedics group explained, “ We have to get this right. ” In most person’s increasingly busy lives, the experience of going to the doctor or treatment center isn’t simply making an appointment and waiting to see a provider anymore. Attention needs to be paid to how patients can move seamlessly from check-in to clinical practice areas to check-out, so that providers can operate efficiently and maximize time with patients. Before proceeding, let’s all agree on the  definition of patient flow . Patient flow represents  every touch point during the patient visit ...

  Healthcare Practices Save Money with Higher Accuracy of Medical Claims Reimbursement for medical practices has been impacted by numerous trends and healthcare industry changes over the past five to ten years. Medicare and Medicaid are constantly cutting physician reimbursement, third-party payers ( UnitedHealth, BCBS, Humana, Anthem, Aetna, Cigna, etc. ) have bargained for fee-for-service contracts with healthcare providers, often bringing about reimbursements at less than 100 percent of charges. Moreover, the Administrative Simplification requirements of the Health Insurance Portability and Accountability Act (HIPPA) have stiffened claims data submission requirements. Add to this the government’s emphasis on healthcare fraud and abuse and compliance have all increased the significance of accurate billing. Because of such concerns, medical practices are being forced to upgrade their revenue cycle management processes. What do we mean by Revenue Cycle Management? The Healthcare...