Category Archives: Medical Billing Services

Prior authorization represented the biggest cost-saving opportunity for providers

Prior authorization represented the biggest cost-saving opportunity for providers

Prior authorization is a check conduct by some insurance companies or third-party payers in the United States before they agree to cover specific prescribed medications or medical procedures for patient. Prior authorization costs accounted for approximate two percent of overall medical industry spending on administrative transactions in last year 2019. Analyzing data from medical plans covering

Is it required to shift Value-Based Care in Primary Care Staffing Model?

Is it required to shift Value-Based Care in Primary Care Staffing Model?

The medical assistant is the only model for primary care staffing can be the most cost-effective for practices relying on fee-for-service revenue. But the this model will not be able to support value-based care and other sophisticated revenue arrangements, Premier recently reported. Physicians will have to reevaluate and tweak the arrangements of their clinical care

Strategies to maximize the effectiveness of Prior Authorizations

Strategies to maximize the effectiveness of Prior Authorizations

Using automated systems, proactive checks, and expert and dedicated staff are three ways that providers can reduce the bad effects of prior authorizations. Prior authorization is a strategy that payers use to control cost and ensure that their insured members receive medically necessary care. Advance approval from payers is required to deliver specific services or

Medical billing performance metrics

Medical billing performance metrics

If you are a medical practitioner are feeling overwhelmed adjusting with medical billing performance metrics the first thing to do right now is to focus on quality coding and track KPIs which will heavily impact your financial performance. The current billing landscape is not a road for many medical practices to navigate. The transformation of

Common claims denials and its solutions for your optometry practice

Common claims denials and its solutions for your optometry practice

If your in-house billing team isn’t fulfilling the duties related to claims management or re unable to suffice the billing management you can’t rely on them. However, today with options to outsource and partnering billing agencies, the income cycle of your practice can steadily move and grow. Due to inefficiency and lack of knowledge towards

Improve your Prior Authorization process

Improve your Prior Authorization process

It is one of the most exasperating challenging tasks for physicians to obtain prior authorizations for prescriptions and testing in their services. In the physician’s percept, prior authorizations are nothing but it’s just insurance companies inserting themselves into the care decision-making process, creating problems for both doctors and patients. Physicians say they have to face

Four vital elements that affect payments and income cycle in medical billing

Four vital elements that affect payments and income cycle in medical billing

The recent changes in the U.S healthcare system have brought with it variety of challenges for healthcare units, patients and insurance companies alike. Staying afloat in such a transition can be a tough task, while the frequent alterations of medical billing and coding rules and regulations, can cause income loss. Crossing the Hurdle Though economist

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