Medical practices face several challenges that can hinder efficiency and impact revenue cycles. One aspect that the front office often has problems handling is checking patients’ insurance coverage. While a patient's insurance coverage may seem straightforward, not...
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Diagnostic Errors Rank High Among the Most Harmful Medical Mistakes
A new study published in the BMJ Quality & Safety Journal by a group of researchers at the Johns Hopkins University School of Medicine found diagnostic errors to be the most common and costly...
Move towards Healthcare for Angel Investments
A significant trend has emerged in angel investments in the United States. Angel investor groups are heading towards healthcare, if research on the first quarter of the current financial year is to...
Vital Points to Remember Regarding ERISA
Physicians and organizations need to know that only patients have the provision under the ERISA law to appeal. Medical billers and healthcare providers have no rights at all - this is indeed the...
Reimbursement for Ultrasound Guided Pain Management
Healthcare providers in any medical specialty should submit claims with appropriate medical codes and modifiers to receive proper reimbursement for services provided. This holds true for the...
Preexisting Condition Exclusions under HIPAA – An Overview
Pre-existing condition exclusion signifies a limitation or exclusion of benefits for a health condition on the grounds that it was present before the coverage begins irrespective of whether any...
Increased Administrative Costs Shutting Down Physician Private Practices
A recent report CNNMoney report states that physicians in the U.S. have started selling their private practices to big hospitals because of rising business costs and falling reimbursements from...
Implications of the Retail Clinic Model for Conventional Healthcare
According to a new study by Accenture, the number of retail clinics will increase rapidly over the next few years as the Affordable Care Act (ACA) seeks to extend heath coverage to millions of...
Guidelines for Using ‘Separate Procedure’ CPT Codes
The AMA Current Procedural Terminology (CPT) lists a term ‘Separate Procedure’ under surgery guidelines. The term refers to the procedures and services performed as integral components of a total...
Implications of the Obamacare Employer Mandate Delay
The Obamacare Employer Mandate, one of the most vaunted provisions of the Affordable Care Act (ACA), was supposed to come into effect in 2014. The mandate insists that companies with more than 50...
What is HEDIS Coding?
The Healthcare Effectiveness Data and Information Set (HEDIS) is set of norms employed by most of the healthcare plans in the US for measuring performance in relation to service and care. HEDIS was...