Know their methodologies so you can use them to your financial advantage, not detriment. Third-party pricing companies may be a foreign entity among participating providers, but for non-participating providers they have become an obstacle in fair/correct insurance reimbursement. In-network rates are typically fixed and less than “fair market” rates. Out-of-network rates are more fluid and ...
In CMS
Nov 6th, 2018
What does the cost of rising health insurance mean for you? By Wendy Dressler Image via Pexels There are a lot of changes coming to the world of healthcare and health insurance. It’s no secret that the cost of health coverage is rising, and this has led to one of the most profitable years for ...
In Billing
Aug 9th, 2018
With diligence and quick follow-through, you can recoup payments rightfully due to providers. Managing payer denials is key to proper reimbursement. The lack of appropriate and timely claim follow-up can cost even the most successful practice significant revenue. Although appeals take time and effort, the recoupment of lost payments makes the process profitable. Rejection and ...
When excessive skin becomes a problem, documentation must prove removal is necessary, not cosmetic. By Victoria Moll, CPC, CPMA, CPRC One-third of the adult U.S. population is considered obese. With all the associated health risks, such as hypertension, heart disease, and diabetes, this condition has been a big focus for many healthcare organizations. Insurance companies ...
Factor in the pros and cons of each to make an educated decision for your practice. If you are wondering whether your provider should be in or out of network with certain insurance plans, take a deep breath and remember: It’s different for every practice, so weigh the pros and cons. Out-of-Network Insurance Providers may ...