Tips for Effective Physician Practice Management

As the non-medical activities in private practice increase over time it become complex and challenging to manage. However, the current pandemic have made it even more so. Outsourcing your billing functions would be a better option so that billing company will handle the billing functions of a medical practice, while the physicians focus their energy […]

How should MA Organization approach HCC Coding?

Most of the healthcare provider that accepts Medicare Advantage Plans (MA) are using Hierarchical Condition Category (HCC) coding. HCC models are designed to predict the health spending for a specific patient population as well as in these models the risk is equal to the level of expected healthcare spending. Healthcare plans and healthcare facilities utilize […]

Things to Remember for Internal Medicine Practices

You may find that there is confusion between family physician and Internal medicine physicians. The confusion arises because of the treatment of adult patients. Most of adult patient treatments are carried out by family physicians while Internal medicine physicians only treat adults. However, there are some notable differences between internal medicine and other specialties. In […]

How to increase collection and reduce AR days?

A well-organized revenue cycle management is critical to upholding good finances. The healthcare revenue cycle is important to healthcare providers’ capability to uphold physician compensation, reduce overhead, and introduce new technologies. When the healthcare revenue cycle is not managed well, collection drops and accounts receivable (AR) days increase. Many tasks go into the revenue cycle, […]

The Factors to Consider Before Outsourcing Medical Billing

You often observed that instead of enjoying the benefits of outsourcing medical billing, many medical practices process billing with in-house staff and hold the responsibility for the potential complications that come with the billing process. Even though you have skilled staff and a dedicated billing department, small errors in the medical billing will results in […]

Telemedicine Billing Tips You Need to Know

Telemedicine is a new rising technology that has great potential to address some of the challenges faced by both developed and developing countries in providing accessible, cost-effective, high-quality health care services. Telemedicine uses advanced technologies to overcome geographical barriers and increase access to health care services which is the main reason it is playing a […]

How to Streamline Physician Credentialing Process?

In healthcare, Physician Credentialing is the key process of organizing and verifying a doctor’s professional records. Every physician have to be credentialed with payers to get reimbursement for patients with insurance. We submit credentialing application within 7 days or as soon as we receive CAQH and required documents from physicians. Generally standard credentialing process takes […]

How HME Billing Differ From DME Billing?

You need to build strong foundation for your medical equipment billing system for which you should understand HME billing and DME billing in detail along with differences between them. Let’s start with the basics. HME billing and DME billing are two main types of billing for medical equipment providers. It is observed that there is […]

Pharmacy Benefit Manager Standards under the Affordable Care Act

CMS considers the finalization of policies related to the 2022 PPACA (Patient Protection and Affordable Care Act) plan year in which CMS’ proposed to ensure calculations of medical loss ratio (MLR) exclude drug rebates and price concessions as well as provide transparency via pharmacy benefit manager (PBM) reporting requirements. CMS has focused its efforts and […]

Difference Between Medical Billing And Pharmacy Billing

It has been widely observed that nowadays pharmacists have an expanded scope of practice by incorporating more clinical aspects into routine patient care like chronic disease management, care transitions interventions, and medication therapy management. For these clinical services to be sustainable, pharmacists must be able to receive payment for the resources and time dedicated to […]