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Appealing a Claim Denied Due to Lack of Authorization

Appealing a Claim Denied Due to Lack of Authorization

When it comes to navigating the managed care world, the system can be streamlined, efficient and profitable as long as the proper procedures are followed. However, when it comes to authorization for services rendered outside of the primary care physician’s (PCP) office, these procedures must be followed precisely otherwise an office runs the risk of …

What impact will ICD-10 have on the practice?

What impact will ICD-10 have on the practice?

ICD-10 The much anticipated ICD-10 has been in the works for since 1983 and it promises to provide for greater accuracy in diagnostic coding. In fact, ICD-10 includes 155,000 codes which is a significant increase as compared to the 17,000 that were available in ICD-9CM. These greater coding options will be critical to accurate and …

CMS Contract to Ensure Physician Incentive Payments

CMS Contract to Ensure Physician Incentive Payments

Hewlett-Packard Awarded CMS Contract to Ensure Physician Incentive Payments It was reported in October 2010 that Hewlett-Packard (HP) and the Centers for Medicare and Medicaid Services (CMS) had entered into a contract that called for HP to maintain CMS’s Integrated Data Repository (IDR) and thereby provide data quality services that will improve the accuracy of …

How do I control my off-site billing service?

How do I control my off-site billing service?

Maintaining Control of an Off-Site Service One of the big concerns that medical practices have when it comes to hiring a remote service provider for such duties as billing is worries over how to maintain control over the process. After all, if you were to have issues you would like to review with the billing …

Should I outsource my medical billing out of state?

Should I outsource my medical billing out of state?

From the Atlantic to the Pacific: Using an Out-of-State Medical Biller When it comes to organic produce, local is probably best. Looking for a plumber?   Using a guy from your zip code is probably the way to go. However, when it comes to outsourcing medical office services such as billing and credentialing it can prove …

How to Make the Most of Medicare Reimbursements in 2011

How to Make the Most of Medicare Reimbursements in 2011

How to Make the Most of 2011 Medicare Reimbursement Every summer, medical practice office managers as well as physicians anxiously await the release of Medicare reimbursement rates for the following year. While reports leading up to the big reveal usually let them know which way the scale will be tipping, in these tough economic times …

Credentialing – Keeping it In-House vs. Outsourcing

Credentialing – Keeping it In-House vs. Outsourcing

Credentialing: Keeping It In-House vs. Outsourcing Credentialing and recredentialing can be a major headache for many medical practices.  The process can be tedious, time-consuming and frustrating.  Further, most offices do not have the staffing to dedicate one employee to the entire process. In some cases, these credentialing responsibilities are very “hit and miss”. It is …

Upset over premium increases? Read on…

Upset over premium increases? Read on…

Thankfully, we have some news that does not include politics, what is or is not being built in Manhattan, the plugged oil well in the Gulf and the worst kept secret of the year, where is Chelsea Clinton getting married.  We found some great news, sort of, on a pay cut for a CEO. Despite …