Reading Time: 3 minutes Recently the HHS Office of the Inspector General published a report calling out that Medicare Advantage organizations (MAOs) sometimes delayed or denied beneficiaries access to services even though the request met the traditional Medicare coverage rules. To compile the report, a list of prior authorization and payment denials from a one-week period in June 2019 […]
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Reading Time: 5 minutes Timely and correct reimbursement is always top of mind for a healthcare provider. However, many providers are leaving money on the table due to infrequent payer contract renegotiations. Due to the nature of payer contracts, which includes fee schedules, reimbursement requirements, as well as conditions payers must meet for timely reimbursement. Therefore, payer contract […]
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Reading Time: 4 minutes Utilization of Social Determinants of Health in Healthcare Social determinants of health (SDOH) refer to the non-genetic and non-medical conditions in the places people live, learn, work and play that affect health and quality-of-life risks and outcomes. Factors such as economic stability, education, food, housing, transportation, community, and social situations all feed into the social […]
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Reading Time: 4 minutes There are many rules and regulations around accepting Medicare, Medicaid, and other federal healthcare programs. And if you are a practice that accepts and bills for these federal government programs, it is your responsibility to ensure you are protecting patients from things such as fraud and abuse. To that end, you need to know the […]
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Reading Time: 4 minutes There was a time when the words patient and consumer meant two different things. Practitioners were not concerned with consumers, just patients, and felt that “consumer” or “customer” cheapened their skills and importance. But more and more patients expect a consumer-centric experience regarding their medical care. Gone are the days of a supply-driven system organized […]
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Reading Time: 3 minutes The pandemic has been blamed for many of the problems happening in the world; however, it didn’t cause the shortage of healthcare workers. It did, however, compound it in a big way. It is estimated that nearly one in five healthcare workers has resigned since March 2020. Not only is there a severe shortage of […]
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Reading Time: 3 minutes We have all heard of HIPAA, and most of us associate it with the safekeeping of personal health information collected by providers, healthcare practices, and facilities. However, the HIPAA Privacy Rule also mandates that you provide adequate access to patients to information found in “a designated record set” or their medical records. The rule allows […]
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Reading Time: 4 minutes The past two years have brought financial and emotional hardship for millions of people. It is natural, as a physician, to want to empathize with patients by providing lenient policies on payments. Especially for those struggling to get by on a limited income or those who are dealing with the financial fallout from the pandemic. […]
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Reading Time: 2 minutes Orlando, Florida, April 26, 2022 – Billed Right, a nationwide Revenue Cycle Management company founded in 2006, headquartered in Longwood, Florida, announced today the acquisition of Miami-based medical billing company RSI. “We are thrilled to add RSI to our Billed Right family as we are both driven by the same values of building long-term partnerships, […]
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Reading Time: 3 minutes The healthcare landscape has changed considerably over the last couple of years thanks to COVID-19. Whether your practice lost revenue due to a reduction of in-person visits, you are struggling with the Great Resignation situation or both. Your goal at this point is to figure out how to lessen expenses, increase staff, and maintain a […]
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