Tag Archives: medical credentialing services

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

Cardiology Insurance verification services in Houston

Cardiology Insurance verification services in Houston

If you own or run a cardiology facility in Houston insurance verification service becomes an integral part to your medical billing procedure. And if not done precisely, incorrect details cause cost you delayed and denied claims. Often the healthcare staff forgets to update the information and these directly result in your healthcare facility losing out

How ASC (Ambulatory Surgical Center) will reduce healthcare costs?

How ASC (Ambulatory Surgical Center) will reduce healthcare costs?

Ambulatory surgery centers (ASCs) have demonstrated an ability to control costs and save money with improved quality and customer services. ASC’s provide a lower-cost site of care as compared to hospital outpatient departments (HOPDs). There has been a reduction of more than $38 billion per year in the cost of outpatient surgery. Below are a

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

Tips to credential a provider with insurance company

Tips to credential a provider with insurance company

Healthcare facilities, payer networks and hospitals require credentialing to admit a provider in a network or to treat patients at a clinic or hospital. What may look like a straightforward credentialing process is engulfed with complications that can frustrate even the calmest of physicians. Here are some vital tips to credential a provider with insurance

Is your patient experience spoiled due to EHR software?

Is your patient experience spoiled due to EHR software?

Electronic health records (EHRs) are the most important means whose implementation can be widely helpful to improve the safety, quality, and efficiency of health care. This digital makeover of the health care revolution gives scope for personal health information for no direct uses as well, such as research, analysis, public reporting, provider certification and authorization

The time for ACO to be ready for downside risk

The time for ACO to be ready for downside risk

Accountable care organizations (ACOs) are part of the foundation of the healthcare industry’s transition to value-based care and purchasing. The federal government says ACOs could do more to reduce costs and improve care quality. And the organizations can achieve the goals through downside financial risk. ACO programs with higher financial risk levels compared to the

How CMS Will Protect Medicaid Provider Payments?

How CMS Will Protect Medicaid Provider Payments?

CMS’s Existing Initiatives Protect Medicaid In 2014, CMS revised the Medicaid Provider Reassignment Regulation to provide for a new exception to the direct payment requirement for certain providers, which primarily include independent in-home personal care workers. This new regulatory exception authorized a state to make Medicaid payments to third parties on behalf of certain providers.

Final rule for Medicare Advantage and Medicare Part D plans

Final rule for Medicare Advantage and Medicare Part D plans

The CMS (Centers for Medicare & Medicaid Services) issued a final rule on May 16, 2019 that modernizes and improves the Medicare Advantage and Part D programs. Now patient will have transparency into the cost of prescription drug in Part D and will also allow Medicare Advantage plans to negotiate better prices for physician-administered medicines

Oncology Care – Precision Medicine Can Lower Drug Cost

Oncology Care – Precision Medicine Can Lower Drug Cost

There is a lot of connection between the terms “precision medicine” and “personalized medicine.” According to the National Research Council, “personalized medicine” is an older term with a meaning similar to “precision medicine.” Precision medicine is a method to patient care that allows doctors to select treatments that are most likely to help patients based

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