Failure to obtain proper prior authorization is one of the key reasons for claim denials in many medical specialties, and radiology is no exception. Radiology prior authorization is meant to ensure that physicians follow proven guidelines when ordering imaging tests....
Shared medical appointments! What does this increasingly popular paradigm hold for patients, physicians and payers? As a patient, you may be wondering whether you will have to discuss intimate...
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...
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...
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...
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...
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...
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...
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...
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...
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...
