Direct primary care (DPC) is one of the newer forms of plans offered by primary care providers to their patient populations. Some see DPC as an alternative to traditional third-party payment for care and other more recent models such as concierge medicine. Primary care providers are tired of the consumable resources required to submit claims ...
In Audit
Aug 27th, 2019
The Centers for Medicare & Medicaid Services (CMS) knows that a significant amount of money is being overpaid to insurance companies in the Medicare Advantage program, but they have yet to recover these overpayments. That’s about to change. CMS says it will increase the audits being performed on Medicare Advantage risk-adjusted code submissions and apply ...
In Billing
May 29th, 2019
Consumers overspent $18.5 billion on diagnostic imaging in 2017, according to a UnitedHealth Group (UHG) research brief, released May 23. The health insurer attributes the overspending to price gouging by some providers. Echocardiograms in 2017, for example, cost patients anywhere between $210 and $1,830, according to the brief. The average was $480, but UHG says ...
Don’t let the financial stress of billing for a non-participating provider surpass the stress of an emergency visit. A trip to the emergency department (ED) is stressful, enough. Don’t rub salt on a wound by sending a surprise bill for services rendered by an “out-of-network” provider. Take steps to collect payments due and keep patients, ...
In Billing
Apr 29th, 2019
One of the hot topics that just happened at the 2019 HEALTHCON was “Gender Identity: Coding EMRs and Insurance Barriers,” presented by Danielle Erickson, CPC, CCS, and Litriana Shimano, CPC, CMDP, CCP, PCS, AHIMA Approved ICD-10-CM/PCS Trainer. It was a full session that many medical coders and payers attended because transgender medical services are difficult ...