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Patient Ineligibility and Lack of Authorization Creating More Claim Denials

Patient Ineligibility and Lack of Authorization Creating More Claim Denials

by Natalie Tornese | Posted: May 30, 2016 | Insurance Verification and Authorizations

With value-based care, patient eligibility verification and insurance authorization have become key factors to reckon with in medical practice management. In fact, ineligibility and failure to get authorization are the major reasons for payment denials. Fortunately,...
Coding for ACA Preventive Services to Curb Tobacco Use

Coding for ACA Preventive Services to Curb Tobacco Use

by Rajeev Rajagopal | Posted: Dec 9, 2015 | Medical Coding

According to the Centers for Disease Control and Prevention (CDC), more people in the United States are addicted to nicotine (the drug found in tobacco) than any other drug. Many clinics are providing preventive services to help tobacco addicted people to control...
CMS Proposed Changes to 2016 Home Health Payment System

CMS Proposed Changes to 2016 Home Health Payment System

by Outsource Strategies International | Posted: Aug 18, 2015 | Industry News, Resources

This July, the Centers for Medicare and Medicaid Services (CMS) proposed changes to the home health prospective payment system (HHPPS) for the calendar year 2016, which will have a significant impact on home health care billing and for medical billing companies that...
Value-Based Reimbursement Model Highly Beneficial For Primary Care

Value-Based Reimbursement Model Highly Beneficial For Primary Care

by Rajeev Rajagopal | Posted: Aug 17, 2015 | Medical Billing

Primary care compensation has improved substantially, a consequence of physician and hospital reimbursement moving to value-based models based on quality and outcomes, from the earlier fee-for-service model. Healthcare staffing is also witnessing a new trend, with...
OASIS-C Documentation of Surgical Wounds for Medicare Reimbursement

OASIS-C Documentation of Surgical Wounds for Medicare Reimbursement

by Natalie Tornese | Posted: Jul 15, 2015 | Medical Billing

With the advancements in post-operative care management, there is a significant rise in the number of hospital discharges to home healthcare for patients with infected wounds after surgery. Home care facilities provide cost-effective as well as efficient services to...
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