Medical Billing & Credentialing News

Provider-Payer Relationship Under COVID-19 COVID-19 Upset Provider-Payer Relationships The  COVID-19  pandemic has affected most, if not all, businesses everywhere.  For healthcare, in particular, the pandemic and its consequences altered the ways that payers and providers do business with one another. How So? Let’s catch a momentary peek at several of the more immediate effects on payer-provider relationships, consisting of upturns in the instability in patients’ insurance coverage and a drop in the number of patients, particularly for non-essential treatments. From there, let’s review the best ways to respond to these challenges going forward, including expanding services, reexamining contracts and working with payers to provide the best outcomes. To begin, let’s examine how things were prior to the pandemic. How Things were Before COVID-19 Payers and providers functioned in relative harmony prior to the pandemic. Both sides profited from issues such as steady but contr...

  Have Your Patients Been Charged with Surprise Bills for COVID-19 Testing? No doubt, the  Delta-variant  is the driving force behind a new flood of nationwide testing that could translate into more surprise medical bills for those being tested. The CARES Act and  Families First Coronavirus Relief Act  are supposed to ensure free COVID-19 testing for everyone, including those without insurance.  But patients, both the uninsured and those with good coverage, are discovering holes in that coverage. For example, federal law doesn’t compel insurers to include “routine” testing that a growing number of workplaces and schools are currently requiring.  This will certainly increase with the President’s mandate for certain persons to be vaccinated or routinely tested. In fact, research shows there have been numerous instances where patients have experienced high out-of-pocket fees ranging from a few hundred to a few thousand dollars for receiving COVID-19 testi...

Outsourced COVID-19 Testing Billing Advantages COVID-19 Testing Scenario Jude Hunt, 81 years old, said she waited in line for her second PCR test a few weeks ago after her vaccinated housekeeper tested positive for COVID-19. She said she previously contracted COVID herself and received the vaccine, but added, “ After the last two years, I’m not taking any chances .” David Gallego, a medical technician at a mobile testing site, said  he has witnessed the number of people stopping by for COVID tests double the past few weeks,  to about 100 people a day. More Americans are being tested for COVID – and waiting longer for results – as virus cases surge and places from offices to concert venues require people to show proof they aren’t infected.  Laboratories in the U.S. processed an average of 713,000 daily tests for the virus’s genetic material as of August 2, 2021 , according to the Department of Health and Human Services. That’s an increase from about half a million in early...