Texas has one of the most helpful and powerful clean claim laws in the United States. The penalties for a clean claim violation can go all the way up to the payer being required to pay billed charges; that's right billed charges. The basic idea of the law is that a payer has to respond to a clean claim within 30 days (45 days if it is not submitted electronically). In order to utilize the clean claim law effectively you must have a tracking system built into your medical billing process that flags:
1. Which payers are subject to the clean a claim law (not all are),
2. When a claim was submitted,
3. When a request fro information was received from the payer (if you receive one then it stops the 30 day clock until you respond),
4. When your office responded to the information request (this starts the 30 day clock again), and
5. When you received a payment or denial.
The design and implementation of the system and reporting can challenging, but it will pay huge dividends in terms of the penalties from payers and in the way in which you will make payers take notice of your claims next time. At ClaimCare Medical Billing Services we have used our clean claim tracking system extensively and have seen significant rewards for our clients. We have actually received calls from managers at some of our payers that have assured us they would process our claims quickly and asked if we would please stop submitting complaints.
A quick way to get started with using the clean claim law is to pick a specific payer that you believe habitually delays claims beyond 30 days. Find a handful of claims that have gone past 30 days and then test the water with those claims. This will allow you to learn the basics of using the on-line tool provided for submitting complaints and see the impact of your initial complaints.
Article Directory: http://www.articledashboard.com
Friday, October 31, 2008
3 Benefits Of Web-based Electronic Medical Billing Software
When you decide to opt for Web-based medical billing software you will find many great benefits. These include but are not limited to, reduced install and maintenance costs, security from natural disasters, anytime access.
Anytime Access
A major benefit of a Web-based medical billing solution is that you can access the information anytime. Whether you are at home, or in the office, you only need an Internet connection and you will be able to access all the information you need. Late at night or early in the morning or during the day you will be able to access the information for your practice.
Reduced Install and Maintenance costs
Another benefit of the software being Web-based is that there are much lower installation costs. You will see this benefit right up front as it will be the first step that you go through. Another benefit is the reduced maintenance cost. Many server based technologies need to be upgraded and constantly monitored. This can sometimes lead to unexpected costs to help maintain your current system. With Web-based technologies these maintenance costs are much, much, much lower.
Accidents unfortunately happen
As much as we like to think that accidents never happen to us, there is a chance that they just may. Many people use insurance to cover them incase of these major accidents. But many people do not think about what is going to happen to their information in an accident. With Web-based electronic medical billing software there is greater satisfaction in knowing that if an accident where to go through a horrific accident, you would be not lose all of your records. If there were a fire, earthquake, flood and your servers were hit, you would lose all of your client information. But if you had a Web-based software solution, even though your office may be damaged, your records wouldn’t be. You would be able to be up and running in almost no time.
So when deciding between Web-based and server side software remember these major benefits of Web-based medical billing software.
Article Directory: http://www.articledashboard.com
Anytime Access
A major benefit of a Web-based medical billing solution is that you can access the information anytime. Whether you are at home, or in the office, you only need an Internet connection and you will be able to access all the information you need. Late at night or early in the morning or during the day you will be able to access the information for your practice.
Reduced Install and Maintenance costs
Another benefit of the software being Web-based is that there are much lower installation costs. You will see this benefit right up front as it will be the first step that you go through. Another benefit is the reduced maintenance cost. Many server based technologies need to be upgraded and constantly monitored. This can sometimes lead to unexpected costs to help maintain your current system. With Web-based technologies these maintenance costs are much, much, much lower.
Accidents unfortunately happen
As much as we like to think that accidents never happen to us, there is a chance that they just may. Many people use insurance to cover them incase of these major accidents. But many people do not think about what is going to happen to their information in an accident. With Web-based electronic medical billing software there is greater satisfaction in knowing that if an accident where to go through a horrific accident, you would be not lose all of your records. If there were a fire, earthquake, flood and your servers were hit, you would lose all of your client information. But if you had a Web-based software solution, even though your office may be damaged, your records wouldn’t be. You would be able to be up and running in almost no time.
So when deciding between Web-based and server side software remember these major benefits of Web-based medical billing software.
Article Directory: http://www.articledashboard.com
Medical Billing And Coding Online Schools
Online Medical Billing and Coding Specialist Schools teach courses that focus on the administration of Medical Billing and Coding for purposes of proper categorization of medical procedures and accurate billing processes. Students of Medical Billing and Coding will be prepared with those skills essential for Medical Billing and Coding processes and for Certified Medical Coding and Billing Specialist examinations for certification.
Online Medical Billing and Coding Specialist Schools train students specifically in the universal language that was developed for the purpose of streamlining medical insurance claims that ensure correct reimbursement from insurance companies for services rendered. Every symptom, diagnosis, procedure, and treatment has been assigned a numeric code that informs the insurance company which services were administered in a hospital, a doctor's office, a clinic, or other medical facility. This numeric language is used by Medical Billing and Coding Specialists to establish the exact services provided. The Medical Billing and Coding Specialist determines these codes and makes a selection based on information provided by the care provider, then processes the claim.
Online Medical Billing and Coding students can expect to study medical terminology, anatomy and physiology, reimbursement methods, law and ethics that apply to medicine, information management, and practices of various office environments.
Additionally, courses in Medical Billing and Coding will prepare students with professional skills that will allow for management of records, preparation of insurance forms, correct filing of claims, and for billing insurance companies for services rendered.
Responsibilities of a Medical Billing and Coding Specialist involve the accurate completion of billing and medical claim forms, appropriate billing, and good understanding of individual insurance company policies and procedures. Medical Billing and Coding Specialists can expect to work for hospitals, medical practitioners, medical clinics, and physical therapists, where efficient and well-prepared Medical Billing and Coding Specialists will manage billing and coding processes.
If you are interested in learning more about Online Medical Billing and Coding Schools please search our site for more in-depth information and resources.
DISCLAIMER: Above is a GENERAL OVERVIEW and may or may not reflect specific practices, courses and/or services associated with ANY ONE particular school(s) that is or is not advertised on our website.
Copyright 2007 - All Rights Reserved in association with Media Positive Communications, Inc.
Article Directory: http://www.articledashboard.com
Online Medical Billing and Coding Specialist Schools train students specifically in the universal language that was developed for the purpose of streamlining medical insurance claims that ensure correct reimbursement from insurance companies for services rendered. Every symptom, diagnosis, procedure, and treatment has been assigned a numeric code that informs the insurance company which services were administered in a hospital, a doctor's office, a clinic, or other medical facility. This numeric language is used by Medical Billing and Coding Specialists to establish the exact services provided. The Medical Billing and Coding Specialist determines these codes and makes a selection based on information provided by the care provider, then processes the claim.
Online Medical Billing and Coding students can expect to study medical terminology, anatomy and physiology, reimbursement methods, law and ethics that apply to medicine, information management, and practices of various office environments.
Additionally, courses in Medical Billing and Coding will prepare students with professional skills that will allow for management of records, preparation of insurance forms, correct filing of claims, and for billing insurance companies for services rendered.
Responsibilities of a Medical Billing and Coding Specialist involve the accurate completion of billing and medical claim forms, appropriate billing, and good understanding of individual insurance company policies and procedures. Medical Billing and Coding Specialists can expect to work for hospitals, medical practitioners, medical clinics, and physical therapists, where efficient and well-prepared Medical Billing and Coding Specialists will manage billing and coding processes.
If you are interested in learning more about Online Medical Billing and Coding Schools please search our site for more in-depth information and resources.
DISCLAIMER: Above is a GENERAL OVERVIEW and may or may not reflect specific practices, courses and/or services associated with ANY ONE particular school(s) that is or is not advertised on our website.
Copyright 2007 - All Rights Reserved in association with Media Positive Communications, Inc.
Article Directory: http://www.articledashboard.com
Tuesday, October 21, 2008
Got Stomach Flab? Quickly Remove Stomach Flab With This Powerful Dieting Solution
Alright guys, today in this article, we're going to talk about how you can quickly remove stomach flab with the following powerful dieting solution. I hope you're ready....because this is going to knock your socks off!
Okay, first things first. Let's talk about the basic core principles. Let me tell you, if you don't comprehend, implement, and practice the basic core principles of a healthy lifestyle, ladies and gentleman....results will be minimal to none....it's just as simple as that.
What are those principles? Proper nutrition (complex carbs, healthy fats, fiber, protein, and foods rich in vitamins and minerals), drink plenty of water daily ( I recommend for you to drink 1/2 to 1 gallon of water daily for optimal results), get plenty of sleep every night (7-8 hours of sleep every night is ideal), cardio exercise (if you want to remove stomach flab fast, do yourself a favor and do high intensity cardio exercise guys), and weight training exercise (building lean muscle is absolutely essential for fat loss and weight loss).
Now let's get down to business! Are you ready? Are you prepared to receive this breakthrough dieting solution to quickly remove stomach flab? Ladies and gentleman....drum roll please.....the 2008 dieting solution of the year to remove stomach flab is... consistency.
"What the"?! "I thought it was going to be some super secret!" Was that one of your responses? If so, don't feel bad, that's usually the response everyone gives.
Why is consistency so shocking to people as being the best dieting solution? It's because people are so brain washed into thinking that there are miracles, potions, and secrets to fat loss.....and it just isn't. Guys, it comes down to the basics of a healthy lifestyles, and STAYING CONSISTENT with it all to quickly remove stubborn stomach flab. The more consistent you are with a diet, the faster the results....it's just that simple!
Looking for a way to "remove stomach flab" fast? I highly recommend for you to check out the brand new breakthrough diet of the decade....The Everloss Diet. With The Everloss Diet, you'll get a complete diet plan that covers every aspect of healthy living and weight loss from food and diet, to activities, to supplements, recipes, fat burning techniques, and an inside view of how your body type works at your age.
Find out more extensive information about how to lose weight and get faster fat loss now at http://Ever-Loss-Diet.info
Article Source: http://EzineArticles.com/?expert=Avy_Barnes
Okay, first things first. Let's talk about the basic core principles. Let me tell you, if you don't comprehend, implement, and practice the basic core principles of a healthy lifestyle, ladies and gentleman....results will be minimal to none....it's just as simple as that.
What are those principles? Proper nutrition (complex carbs, healthy fats, fiber, protein, and foods rich in vitamins and minerals), drink plenty of water daily ( I recommend for you to drink 1/2 to 1 gallon of water daily for optimal results), get plenty of sleep every night (7-8 hours of sleep every night is ideal), cardio exercise (if you want to remove stomach flab fast, do yourself a favor and do high intensity cardio exercise guys), and weight training exercise (building lean muscle is absolutely essential for fat loss and weight loss).
Now let's get down to business! Are you ready? Are you prepared to receive this breakthrough dieting solution to quickly remove stomach flab? Ladies and gentleman....drum roll please.....the 2008 dieting solution of the year to remove stomach flab is... consistency.
"What the"?! "I thought it was going to be some super secret!" Was that one of your responses? If so, don't feel bad, that's usually the response everyone gives.
Why is consistency so shocking to people as being the best dieting solution? It's because people are so brain washed into thinking that there are miracles, potions, and secrets to fat loss.....and it just isn't. Guys, it comes down to the basics of a healthy lifestyles, and STAYING CONSISTENT with it all to quickly remove stubborn stomach flab. The more consistent you are with a diet, the faster the results....it's just that simple!
Looking for a way to "remove stomach flab" fast? I highly recommend for you to check out the brand new breakthrough diet of the decade....The Everloss Diet. With The Everloss Diet, you'll get a complete diet plan that covers every aspect of healthy living and weight loss from food and diet, to activities, to supplements, recipes, fat burning techniques, and an inside view of how your body type works at your age.
Find out more extensive information about how to lose weight and get faster fat loss now at http://Ever-Loss-Diet.info
Article Source: http://EzineArticles.com/?expert=Avy_Barnes
Find Out How to Blast Your Metabolism to the Moon and Lose 5 Pounds in 1 Week!
Just 1 week....safely! Ready for lift off Captain in 5, 4, 3, 2..,
*Attention mission control*.... We have brief problem we need to address first: Do you know and understand the basic core principles of a healthy lifestyle? Without understanding, and implementing these principles, results will be minimal to none.
The basic core principles of a healthy lifestyle are proper nutrition (protein, complex carbs, fiber, healthy fats, and foods rich in vitamins and minerals), drink plenty of water daily (I recommend 1/2 to 1 gallon of water daily for optimal results), get plenty of sleep every night (7-8 hours is ideal), cardio exercise (high intensity cardio works best), and weight training exercise.
*Attention mission control*....Commence with lift off!
Metabolism Booster #1 - Eat more! That's right! One of the easiest ways to boost your metabolism fast is by eating more frequently through out the day. Start with breakfast and have a small healthy meal every 2-3 hours after. Eating more frequently will keep your digestive system active, which will cause a significant boost in your metabolism.
Metabolism Booster #2 - Intense workouts! Getting more intense with your workouts will boost your metabolism and the rate at which you'll burn off fat. Some of my favorite high intensity workouts would be incline treadmill and sprinting!
Metabolism Booster #3 - Ice Cold Water! Don't just drink regular water....get your water ICE COLD! If you drink ice cold water, you will send your body into thermogenesis (the act of your body warming up fluids to body temperature). That whole process burns off calories!
*Attention mission*.....We have landed our metabolism on the moon! Mission complete and 5 pounds lost in 1 week....woohoo!!
Looking for a way to "lose belly fat" fast? I highly recommend for you to check out the brand new breakthrough diet of the decade....The Everloss Diet. With The Everloss Diet, you'll get a complete diet plan that covers every aspect of healthy living and weight loss from food and diet, to activities, to supplements, recipes, fat burning techniques, and an inside view of how your body type works at your age.
Find out more extensive information about how to lose weight and get faster fat loss now at http://Ever-Loss-Diet.info
Article Source: http://EzineArticles.com/?expert=Avy_Barnes
*Attention mission control*.... We have brief problem we need to address first: Do you know and understand the basic core principles of a healthy lifestyle? Without understanding, and implementing these principles, results will be minimal to none.
The basic core principles of a healthy lifestyle are proper nutrition (protein, complex carbs, fiber, healthy fats, and foods rich in vitamins and minerals), drink plenty of water daily (I recommend 1/2 to 1 gallon of water daily for optimal results), get plenty of sleep every night (7-8 hours is ideal), cardio exercise (high intensity cardio works best), and weight training exercise.
*Attention mission control*....Commence with lift off!
Metabolism Booster #1 - Eat more! That's right! One of the easiest ways to boost your metabolism fast is by eating more frequently through out the day. Start with breakfast and have a small healthy meal every 2-3 hours after. Eating more frequently will keep your digestive system active, which will cause a significant boost in your metabolism.
Metabolism Booster #2 - Intense workouts! Getting more intense with your workouts will boost your metabolism and the rate at which you'll burn off fat. Some of my favorite high intensity workouts would be incline treadmill and sprinting!
Metabolism Booster #3 - Ice Cold Water! Don't just drink regular water....get your water ICE COLD! If you drink ice cold water, you will send your body into thermogenesis (the act of your body warming up fluids to body temperature). That whole process burns off calories!
*Attention mission*.....We have landed our metabolism on the moon! Mission complete and 5 pounds lost in 1 week....woohoo!!
Looking for a way to "lose belly fat" fast? I highly recommend for you to check out the brand new breakthrough diet of the decade....The Everloss Diet. With The Everloss Diet, you'll get a complete diet plan that covers every aspect of healthy living and weight loss from food and diet, to activities, to supplements, recipes, fat burning techniques, and an inside view of how your body type works at your age.
Find out more extensive information about how to lose weight and get faster fat loss now at http://Ever-Loss-Diet.info
Article Source: http://EzineArticles.com/?expert=Avy_Barnes
Friday, October 17, 2008
Spend Less Time on Your Medical Billing
A busy medical practice can be challenging because of much-needed organization. The schedule can be difficult to work with and the patients must be seen and cared for. Because of all of the details, sometimes billing will be put on hold for tomorrow. The billing portion of the busy office is the portion of running a busy office, which cannot be allowed to slide. The office needs to collect the money for the office to be able to pay their obligations.
You will need to organize your office in order to save time, which will also help cut down your costs of running the office. In a physician's office information is extremely important. You cannot afford to lose any information. By organizing your office you will have a better chance of know where everything is. Then you will want to make sure all the other employees in the office know where everything is suppose to be to eliminate the chance of any information being misplaced.
A good time saver is the implementation of a web based medical billing software. The web based medical billing software is intended to eliminate or reduce paperwork in your office. It will assist with the billing and keep information organized. The recovery of records, information and past due billing information is simple and easy. Processing claims with the insurance companies will reduce delays and non-payments. The web based medical billing software has been incorporated with the diagnosis and procedure codes to reduce or eliminate errors, which can be the cause of delays, or denied claims. The information, which is stored by the server of the software, is backed up in a secure online server and not your computer's hard drive. Most of these companies with the software will provide training for the use of the software. If the software is created to work with Windows or Microsoft Office, you might receive a video and materials for your and all of your staff on the operating procedure of the software.
The Electronic Medical Records are included in many of the web based medical billing software. This feature will allow you to file medical histories of your patients into the software. You can also scan the information and in some cases you will be able to dictate information, which a transcriber will access from another computer and input into the software. This feature of your web based medical billing software will make it simple to contract someone to transcribe dictation for you or even do the medical billing for you.
If it is easier and less expensive for you, you may want to relinquish your medical billing to a medical billing service. The companies doing this type of work will have training and software in order to get the job done, which can relieve your office to do what it does best. That is taking care of patients. The service will keep all of your information organized, so you will be able to get any information from the service quickly.
Article Source: http://EzineArticles.com/?expert=Evan_Lagasse
You will need to organize your office in order to save time, which will also help cut down your costs of running the office. In a physician's office information is extremely important. You cannot afford to lose any information. By organizing your office you will have a better chance of know where everything is. Then you will want to make sure all the other employees in the office know where everything is suppose to be to eliminate the chance of any information being misplaced.
A good time saver is the implementation of a web based medical billing software. The web based medical billing software is intended to eliminate or reduce paperwork in your office. It will assist with the billing and keep information organized. The recovery of records, information and past due billing information is simple and easy. Processing claims with the insurance companies will reduce delays and non-payments. The web based medical billing software has been incorporated with the diagnosis and procedure codes to reduce or eliminate errors, which can be the cause of delays, or denied claims. The information, which is stored by the server of the software, is backed up in a secure online server and not your computer's hard drive. Most of these companies with the software will provide training for the use of the software. If the software is created to work with Windows or Microsoft Office, you might receive a video and materials for your and all of your staff on the operating procedure of the software.
The Electronic Medical Records are included in many of the web based medical billing software. This feature will allow you to file medical histories of your patients into the software. You can also scan the information and in some cases you will be able to dictate information, which a transcriber will access from another computer and input into the software. This feature of your web based medical billing software will make it simple to contract someone to transcribe dictation for you or even do the medical billing for you.
If it is easier and less expensive for you, you may want to relinquish your medical billing to a medical billing service. The companies doing this type of work will have training and software in order to get the job done, which can relieve your office to do what it does best. That is taking care of patients. The service will keep all of your information organized, so you will be able to get any information from the service quickly.
Article Source: http://EzineArticles.com/?expert=Evan_Lagasse
Take Your Medical Billing Business to the Next Level
Do you have your own Medical Billing Business? Is it doing as well as you would like it to be? Do you want to grow but not sure how to get started? Maybe you've been cruising along now at the same place for a while and you're ready for a change. Whatever your situation is, if you are ready to Take Your Medical Billing Business to the Next Level then you will need a plan.
Many people want to grow their business but they just sit and wait for it to happen on its own. If you want your business to grow then you need to act first. Don't sit around waiting and wondering when. If you do that you will have no control over how fast you grow and what direction you grow in. You need a plan.
First, sit down and figure out exactly what it is you want. How much do you want to grow? Do you want to just pick up a few more clients? Do you want to double? Are you ready to hire an employee or two? Maybe you are ready to quit your full time job and work at your medical billing business full time. After you figure out how much you want to grow you need to figure out what it will take to get you there.
Your plan for getting there will involve many things. You will need to plan a marketing strategy. You will need to consider many new things if you need to hire and train an employee. Your work space must be taken into consideration. You will need to consider the costs of expansion. And you will need to learn to put many systems in place.
After you decide how much you want to grow you need to give yourself a time frame and a set of steps to reach your goal. A goal without a deadline is just a dream. Set specific dates that you want to reach certain parts of your goal. They can be flexible. If you don't reach a goal by the set date, you can move it a little. It doesn't mean you have to give up. A time frame makes sure you are keeping on track to reach your goal. If you don't meet a deadline maybe you need to rethink how you are trying to get there and make some changes.
The important thing is that you take control of your business. If you want growth, prepare for it, decide what you want, and when you want to be there. Then go for it! Good luck.
Article Source: http://EzineArticles.com/?expert=Michele_Redmond
Many people want to grow their business but they just sit and wait for it to happen on its own. If you want your business to grow then you need to act first. Don't sit around waiting and wondering when. If you do that you will have no control over how fast you grow and what direction you grow in. You need a plan.
First, sit down and figure out exactly what it is you want. How much do you want to grow? Do you want to just pick up a few more clients? Do you want to double? Are you ready to hire an employee or two? Maybe you are ready to quit your full time job and work at your medical billing business full time. After you figure out how much you want to grow you need to figure out what it will take to get you there.
Your plan for getting there will involve many things. You will need to plan a marketing strategy. You will need to consider many new things if you need to hire and train an employee. Your work space must be taken into consideration. You will need to consider the costs of expansion. And you will need to learn to put many systems in place.
After you decide how much you want to grow you need to give yourself a time frame and a set of steps to reach your goal. A goal without a deadline is just a dream. Set specific dates that you want to reach certain parts of your goal. They can be flexible. If you don't reach a goal by the set date, you can move it a little. It doesn't mean you have to give up. A time frame makes sure you are keeping on track to reach your goal. If you don't meet a deadline maybe you need to rethink how you are trying to get there and make some changes.
The important thing is that you take control of your business. If you want growth, prepare for it, decide what you want, and when you want to be there. Then go for it! Good luck.
Article Source: http://EzineArticles.com/?expert=Michele_Redmond
Basics of Medical Billing
Whether you are planning on starting a medical billing business, already own a medical billing business, work for a billing service or in a medical office, it is crucial that you completely understand the entire billing process. From the time a patient schedules an appointment to the time that full payment is received, everyone who interacts with either the patient or the billing process can affect the payment.
Billing is such an important part of a medical office. The money brought in from the billing is what keeps the office running. It pays everyone's salary, including the doctor. It always amazes me that so many providers do not make sure that their billing is being done properly and that their office staff isn't all working together to make sure all is being done that needs to be.
When a patient calls to schedule an appointment it is important that the person doing the scheduling not only gets all of the necessary information from the patient but also that they understand how insurance works so they can tell if anything needs to be done prior to the patient's appointment. Having someone who understands medical billing can reduce visits that end up not being covered by insurance.
The person responsible for actually submitting the insurance claims needs to know the different requirements by each carrier and understand how to handle all aspects of billing. Following up on unpaid insurance claims is an area that most offices lose a ton of money. If you don't have a very good follow up system then you are definitely losing money.
Many medical providers think that only the billing person needs to understand medical billing. Actually it is important that all staff have some knowledge of insurance billing in order for things to run smoothly. The more that the staff understands, the less money you throw out the door. Providers deserve to be paid for all the patients they treat.
Article Source: http://EzineArticles.com/?expert=Michele_Redmond
Billing is such an important part of a medical office. The money brought in from the billing is what keeps the office running. It pays everyone's salary, including the doctor. It always amazes me that so many providers do not make sure that their billing is being done properly and that their office staff isn't all working together to make sure all is being done that needs to be.
When a patient calls to schedule an appointment it is important that the person doing the scheduling not only gets all of the necessary information from the patient but also that they understand how insurance works so they can tell if anything needs to be done prior to the patient's appointment. Having someone who understands medical billing can reduce visits that end up not being covered by insurance.
The person responsible for actually submitting the insurance claims needs to know the different requirements by each carrier and understand how to handle all aspects of billing. Following up on unpaid insurance claims is an area that most offices lose a ton of money. If you don't have a very good follow up system then you are definitely losing money.
Many medical providers think that only the billing person needs to understand medical billing. Actually it is important that all staff have some knowledge of insurance billing in order for things to run smoothly. The more that the staff understands, the less money you throw out the door. Providers deserve to be paid for all the patients they treat.
Article Source: http://EzineArticles.com/?expert=Michele_Redmond
Tuesday, October 14, 2008
Cheaper Medical Insurance - Ideas To Help You Cut Down Costs
Cheaper medical Contrary to what you might have thought, it's quite easy to get a lower rate. The only things that stand between you and attracting a more affordable rate now are relevant information and a motivation to make use of the recommendations you get. Let's look at a few sure-fire ways to get better rates...
1. Ensure a healthy life style and you will get lower rates with time. If you can stop eating junk food you'll pay less over time. Removing fats, cholesterol and high carb from your diet will make it easier for you to retain the right weight, live a healthier life and, as a result, attract cheaper rates.
You will also help your health and rate by going on regular exercise.
2. For folks who have a longtime ailment that makes it hard or too expensive for them to enjoy private personal health insurance, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) insurance could offer a more affordable option.
3. Some persons are not poor enough to qualify for plans for low-income earner and also have financial challenges that make regular health insurance hard to pay for. In case this defines you, then you can reduce your budget for health care by going for a discount medical card. So what are they?
With these cards you are given medical attention from a network of health care professionals who have agreed to render services to card carriers at reduced rates. Such cards are not issued by insurance companies.
You can fall back to this option if you have a medical history that has made health insurance providers either reject you or give you a rate that is too high. One advantage of a discount medical card is that everybody can use it. Just make your monthly payments and you'll have access to a network of health care providers who will bill you lower for their services.
4. Your premiums may be tax-deductible if you're self employed. You may also be entitled to a tax break if your employer offers a flexible spending account. You can get details on this from your tax professional. This will help you know for sure what will entitle you to a tax break and what won't.
5. Don't become carried away by the lowest quote as you shop for low cost health insurance. You want a cheap rate that also offers you much value. If the cheapest price has all that is important to you, then go for it. But in situations where you don't find the right value in the cheapest rate, you'll be making the right choice if you pay more to ensure you truly have the quality of coverage that you really need.
Take note of this because a number of low quotes are that low because they don't offer much. A health insurance plan that compromises you does not make sense even if it's 500% less than the quote that offers you sufficient coverage.
6. You will save much if you only have between 25-30 minutes. Visit, obtain and compare health insurance quotes from selected quotes sites. The cheapest offer should be your choice easily. However, you have to look beyond just the lowest quote to the best price to value ratio. The cheapest may not be the best price/value for you as an individual.
Here are great pages for health insurance quotes...
Article Source: http://EzineArticles.com/?expert=Chimezirim_Chinecherem_Odimba
1. Ensure a healthy life style and you will get lower rates with time. If you can stop eating junk food you'll pay less over time. Removing fats, cholesterol and high carb from your diet will make it easier for you to retain the right weight, live a healthier life and, as a result, attract cheaper rates.
You will also help your health and rate by going on regular exercise.
2. For folks who have a longtime ailment that makes it hard or too expensive for them to enjoy private personal health insurance, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) insurance could offer a more affordable option.
3. Some persons are not poor enough to qualify for plans for low-income earner and also have financial challenges that make regular health insurance hard to pay for. In case this defines you, then you can reduce your budget for health care by going for a discount medical card. So what are they?
With these cards you are given medical attention from a network of health care professionals who have agreed to render services to card carriers at reduced rates. Such cards are not issued by insurance companies.
You can fall back to this option if you have a medical history that has made health insurance providers either reject you or give you a rate that is too high. One advantage of a discount medical card is that everybody can use it. Just make your monthly payments and you'll have access to a network of health care providers who will bill you lower for their services.
4. Your premiums may be tax-deductible if you're self employed. You may also be entitled to a tax break if your employer offers a flexible spending account. You can get details on this from your tax professional. This will help you know for sure what will entitle you to a tax break and what won't.
5. Don't become carried away by the lowest quote as you shop for low cost health insurance. You want a cheap rate that also offers you much value. If the cheapest price has all that is important to you, then go for it. But in situations where you don't find the right value in the cheapest rate, you'll be making the right choice if you pay more to ensure you truly have the quality of coverage that you really need.
Take note of this because a number of low quotes are that low because they don't offer much. A health insurance plan that compromises you does not make sense even if it's 500% less than the quote that offers you sufficient coverage.
6. You will save much if you only have between 25-30 minutes. Visit, obtain and compare health insurance quotes from selected quotes sites. The cheapest offer should be your choice easily. However, you have to look beyond just the lowest quote to the best price to value ratio. The cheapest may not be the best price/value for you as an individual.
Here are great pages for health insurance quotes...
Article Source: http://EzineArticles.com/?expert=Chimezirim_Chinecherem_Odimba
Medical Insurance Savings - These Tips Will Help You A Lot
With the right advice you'll get more affordable rates for sufficient coverage. It is also necessary that I point out that there are recommendations that might put you at risk even if they help you make savings at the moment. I will, nevertheless, only make suggestions that will save you much while you still keep enjoying adequate coverage...
1. Even though most individuals know that smoking adds to their rates, they may not know that this also applies if they use other tobacco products. Those who snuff or chew tobacco will also get higher rates than those who don't. Staying away from all tobacco products will attract less expense in health insurance.
2. A group plan is less expensive than an individual plan. Don't miss it if you're in a position that gives you the opportunity of using a group plan as it generally implies that you'll pay lower rates. This statement becomes even more so if you're overweight, a smoker or an older person.
A group plan will help you make considerable savings if you have a pre-existing condition that makes individual health insurance either too costly or almost impossible to come by. A group plan is an easy way to lower your cost without reducing the quality of coverage you will enjoy.
3. You will spend less in health insurance if you if you get the right tips. Individuals who know more about health care and insurance get better deals. Moreover, you will find it easier to get every benefit that you are eligible for if you always have the right information.
There are toll-free numbers you can call if you need help on health matters. One of such numbers is that of the National Health Information Center: 1-800-336-4797
4. Buying your prescriptions on the internet is a proven way to bring down your health care spend. Buying by telephone might as well give you affordable prices. The internet reduces the cost of doing business and pharmaceutical companies or groups who sell their drugs online do so at cheaper rates. But if you've chosen to buy online try to find out a little about whom you are buying from because there are wolves online. Just go to BBB online and you will know if you should buy from an exact company.
Always remember that while we want to reduce costs we also want to avoid risks.
5. Electronic Funds Transfer, known as EFT is an easy way to reduce your premium. By doing this you authorize your insurance provider to automatically withdraw your payments from your account when due. This eliminates administrative overheads like those involved in sending payment notices. Your premium is therefore lowered in line with the cheaper cost of giving you insurance.
6. Visit a minimum of five quotes sites. Using a minimum of five quotes sites raise the chances that you'd receive cheaper health insurance quotes. This is because insurance companies not covered by one site will be represented by the other. Moreover, you know that because your chances of getting lower health insurance quotes has to do with the number of quotes you obtain, the more companies you obtain quotes from, the higher your chances will be. Requesting for your health insurance quotes online will help you save a bundle if you take out around 25 minutes to obtain quotes from at least five sites.
Article Source: http://EzineArticles.com/?expert=Chimezirim_Chinecherem_Odimba
1. Even though most individuals know that smoking adds to their rates, they may not know that this also applies if they use other tobacco products. Those who snuff or chew tobacco will also get higher rates than those who don't. Staying away from all tobacco products will attract less expense in health insurance.
2. A group plan is less expensive than an individual plan. Don't miss it if you're in a position that gives you the opportunity of using a group plan as it generally implies that you'll pay lower rates. This statement becomes even more so if you're overweight, a smoker or an older person.
A group plan will help you make considerable savings if you have a pre-existing condition that makes individual health insurance either too costly or almost impossible to come by. A group plan is an easy way to lower your cost without reducing the quality of coverage you will enjoy.
3. You will spend less in health insurance if you if you get the right tips. Individuals who know more about health care and insurance get better deals. Moreover, you will find it easier to get every benefit that you are eligible for if you always have the right information.
There are toll-free numbers you can call if you need help on health matters. One of such numbers is that of the National Health Information Center: 1-800-336-4797
4. Buying your prescriptions on the internet is a proven way to bring down your health care spend. Buying by telephone might as well give you affordable prices. The internet reduces the cost of doing business and pharmaceutical companies or groups who sell their drugs online do so at cheaper rates. But if you've chosen to buy online try to find out a little about whom you are buying from because there are wolves online. Just go to BBB online and you will know if you should buy from an exact company.
Always remember that while we want to reduce costs we also want to avoid risks.
5. Electronic Funds Transfer, known as EFT is an easy way to reduce your premium. By doing this you authorize your insurance provider to automatically withdraw your payments from your account when due. This eliminates administrative overheads like those involved in sending payment notices. Your premium is therefore lowered in line with the cheaper cost of giving you insurance.
6. Visit a minimum of five quotes sites. Using a minimum of five quotes sites raise the chances that you'd receive cheaper health insurance quotes. This is because insurance companies not covered by one site will be represented by the other. Moreover, you know that because your chances of getting lower health insurance quotes has to do with the number of quotes you obtain, the more companies you obtain quotes from, the higher your chances will be. Requesting for your health insurance quotes online will help you save a bundle if you take out around 25 minutes to obtain quotes from at least five sites.
Article Source: http://EzineArticles.com/?expert=Chimezirim_Chinecherem_Odimba
Sunday, October 12, 2008
CMS 1500 Form - Completing it Correctly
CMS 1500 forms are the universal claim forms used by medical providers to submit claims for their services to the insurance carriers. They are pre-printed red and white forms designed by the Centers for Medicare and Medicaid Services. They were formally known as HCFA 1500 forms but they were redesigned to allow for the reporting of the NPI, or National Provider Identifier.
It is very important that the CMS 1500 forms are completed properly to ensure that correct payment is made. If the form is not completed properly, the claim may be denied by the insurance carrier. Many providers have practice management software that completes the forms for them, but the information must still be loaded into the practice management software program properly in order for it to be printed out in the right format.
Many of the insurance carriers have different requirements for what information goes in each box on the CMS 1500 form. For example, if you are billing an insurance carrier that requires authorization for the services being billed and they assign an authorization number, they may require that the authorization number be in box 23. Other carriers do not require that anything be in box 23. It is important to know the different requirements for each of the insurance carriers that you bill to.
If you do not have all of the necessary boxes completed, or if they are not completed properly, the claim may be denied. For example, if you do not put the patient's date of birth on the CMS 1500 form, then the claim will most likely be denied out. Most insurance carriers scan the CMS forms and if all the required fields are not completed the claim is automatically denied without a human even touching it. Another thing that could cause an immediate denial is if the date of birth on the claim doesn't match what's on file with the insurance carrier. When the claim is scanned, it will deny out stating they can't identify the patient.
Many claims do not get paid on the first submission and in many cases it is due to the CMS form not being completed properly. In order to cut down on denials, make sure you are completing the forms completely and correctly. This will make a big difference in your bottom line.
Article Source: http://EzineArticles.com/?expert=Michele_Redmond
It is very important that the CMS 1500 forms are completed properly to ensure that correct payment is made. If the form is not completed properly, the claim may be denied by the insurance carrier. Many providers have practice management software that completes the forms for them, but the information must still be loaded into the practice management software program properly in order for it to be printed out in the right format.
Many of the insurance carriers have different requirements for what information goes in each box on the CMS 1500 form. For example, if you are billing an insurance carrier that requires authorization for the services being billed and they assign an authorization number, they may require that the authorization number be in box 23. Other carriers do not require that anything be in box 23. It is important to know the different requirements for each of the insurance carriers that you bill to.
If you do not have all of the necessary boxes completed, or if they are not completed properly, the claim may be denied. For example, if you do not put the patient's date of birth on the CMS 1500 form, then the claim will most likely be denied out. Most insurance carriers scan the CMS forms and if all the required fields are not completed the claim is automatically denied without a human even touching it. Another thing that could cause an immediate denial is if the date of birth on the claim doesn't match what's on file with the insurance carrier. When the claim is scanned, it will deny out stating they can't identify the patient.
Many claims do not get paid on the first submission and in many cases it is due to the CMS form not being completed properly. In order to cut down on denials, make sure you are completing the forms completely and correctly. This will make a big difference in your bottom line.
Article Source: http://EzineArticles.com/?expert=Michele_Redmond
Securing An Adequate Cheap Insurance Medical Policy
No matter how healthy your lifestyle, how wisely you plan your diet or how much you exercise in an effort to take care of your body, unexpected situations may arise. You may land in the hospital with bills that could potentially wipe out everything you own. Thus it is extremely important to acquire an adequate insurance medical policy that will take care of your expenses in case of just such an emergency.
Everyone needs at least some form of health insurance. Some people are concerned about qualifying for an insurance plan especially if they have health issues. There are so many options available and although some are not easy to find, they can be quite simple to qualify for.
Before signing up for a plan, consider your family's medical needs and budget requirements. There are basically two types of plans to consider, a private plan and a government plan.
Types of Coverage
The private plan is commonly obtained through employment. Most employers will offer some form of insurance for their full time employees. In some states employers are required to provide insurance if the employee exceeds a certain level of hours worked during the course of a week. Often times the employer will offer some sort of group health plan for their employees which decreases the monthly premium costs. Normally this type of plan will cover your spouse and family. Many people may not be able to participate in group plans. There are many individual plans are offered although they may be a bit more expensive in relation to group plans.
If you are going to sign on with a private plan learn all you can about the coverage in the contract. Read all the inclusions and exclusions and avoid signing up with a plan that has a long list of exclusions. Also make sure you obtain a copy of all the paperwork you sign.
Health insurance offered by the government is generally on a state or national level. One example would be Medicare which is a national plan. Medicare is available for those people over 65 years of age and also is available to disabled people. Some other types of government assisted health care plans include Medicaid which is based on income level, health and care for veterans and children's health programs.
Article Source: http://EzineArticles.com/?expert=Peter_Kingston
Everyone needs at least some form of health insurance. Some people are concerned about qualifying for an insurance plan especially if they have health issues. There are so many options available and although some are not easy to find, they can be quite simple to qualify for.
Before signing up for a plan, consider your family's medical needs and budget requirements. There are basically two types of plans to consider, a private plan and a government plan.
Types of Coverage
The private plan is commonly obtained through employment. Most employers will offer some form of insurance for their full time employees. In some states employers are required to provide insurance if the employee exceeds a certain level of hours worked during the course of a week. Often times the employer will offer some sort of group health plan for their employees which decreases the monthly premium costs. Normally this type of plan will cover your spouse and family. Many people may not be able to participate in group plans. There are many individual plans are offered although they may be a bit more expensive in relation to group plans.
If you are going to sign on with a private plan learn all you can about the coverage in the contract. Read all the inclusions and exclusions and avoid signing up with a plan that has a long list of exclusions. Also make sure you obtain a copy of all the paperwork you sign.
Health insurance offered by the government is generally on a state or national level. One example would be Medicare which is a national plan. Medicare is available for those people over 65 years of age and also is available to disabled people. Some other types of government assisted health care plans include Medicaid which is based on income level, health and care for veterans and children's health programs.
Article Source: http://EzineArticles.com/?expert=Peter_Kingston
Medical Billing Audit, Clean Claims Metrics, And the Payer-Provider Conflict
Dr. Noah Payne shook his head in disbelief: the practice reimbursements shrank instead of climbing in response to the recent hiring of Dr. Inna Ternist. The new doctor clearly added to the total number of patients seen yet overall payments did not reflect the added charges. Perhaps the new claims were not created, submitted, or paid? Dr. Noah remembered noticing the growing pile of rejected and denied claims accumulating dust on his desk - he never had the time to review them...How many of these claims are clean? How many of them require manual review and correction?
Dr. Noah looked at his Vericle screen and began analyzing the numbers. The system showed 58 percent clean claims (PCC). In other words, almost every second claim required manual correction. Who could be causing such a high level of problems: the practice, the billing service, or the payer? Dr. Noah's instinctively felt that perhaps the billing service was negligent about data entry process and kept introducing massive data errors. But the service manager was quick to explain a rigorous quality assurance process for data entry. What else could be causing such a high level of manual work in a seemingly streamlined process?
A quick review shows that PCC varies along several dimensions:
1. 19 and 70 percent for financial class
2. 37 and 66 percent for month of service
3. 55 and 59 percent for physician
4. 29 and 70 percent for various CPT codes
Trying to discover a pattern, Dr. Noah looked for a root cause dimension. He drilled into 99213 - the single largest frequency CPT code for his practice. Vericle showed 3,135 claims and the above average 62 PCC carrying charges and payments for 99213 code.
Having isolated the single most frequent CPT code, Dr. Noah was thinking about other dimensions that influence PCC. He hypothesized that if all doctors in his practice had the same coding skills, and assuming uniform distribution of errors, he should observe no PCC variance across the doctors. Yet, a quick click on a Vericle screen yielded a spread, confirming his suspicion that different doctors maintained slightly different coding skills:
1. Dr. Ted 1,554 claims and PCC = 63%
2. Dr. Lori 865 claims and PCC = 62%
3. Dr. Inna 194 claims and PCC = 61%
4. Dr. Noah 516 claims and PCC = 60%
Next, Dr. Noah switched his attention to distribution of PCC across the financial classes. Again, he hypothesized that if all payers used the same rules to deny claims then there should be no difference in the average PCC for different payers, subject to a uniform distribution of errors over a large sample of submitted and paid claims. Yet the numbers showed a significant (30 percent) variation of PCC for the same CPT code: UHC - 82, Blue Cross Blue Shield - 73, Oxford - 64, Aetna - 59, Medicare - 59, and Cigna - 51, confirming his conclusion that various payers used various rules to deny and underpay claims.
Dr. Noah recalled reading an article about PacifiCare, a Californian insurance company being fined upon an audit. The joint Department of Managed Health Care and Insurance Department recently analyzed 1.1 million paid claims from June 2005 to May 2007 that covered about 190,000 members in PacifiCare's HMO plans and PPO coverage [Gilbert Chan , "PacifiCare fined record $3.5 million," www.sacbee.com , January 30, 2008]. They discovered 30 percent of the HMO claims wrongly denied and 29 percent of the disputes with doctors were handled incorrectly. PacifiCare paid out over $1 million and was fined additional $3.5 million. Dr. Noah's findings roughly matched PacifiCare audit - the insurance companies were failing anywhere between twenty to fifty percent of his claims and each insurance company showed a different failure rate, depending on a system used to fail submitted claims.
Finally, Dr. Noah thought of the billing service operation. Is his billing service systematically working to discover failed claims and improve its response to such discoveries? Is there a pattern of an occasional drop of PCC reflecting its deterioration in response to various payer's initiatives? Conversely, is there any evidence for a systematic improvement effort? A chart of the distribution of a single CPT-code clean claim percentage over the entire year must answer his question. In his mind, PCC should iterate between drops and climbs, hopefully each time at a higher level. Vericle confirmed his expectations, showing an overall improvement of PCC over the year (46% 1-07, 39% 2-07, 52% 3-07, 55% 4-07, 63% 5-07, 67% 6-07, 72% 7-07, 69% 8-07, 72% 9-07, 68% 10-07, 74% 11-07, 73% 12-07)
Article Source: http://EzineArticles.com/?expert=Yuval_Lirov
Dr. Noah looked at his Vericle screen and began analyzing the numbers. The system showed 58 percent clean claims (PCC). In other words, almost every second claim required manual correction. Who could be causing such a high level of problems: the practice, the billing service, or the payer? Dr. Noah's instinctively felt that perhaps the billing service was negligent about data entry process and kept introducing massive data errors. But the service manager was quick to explain a rigorous quality assurance process for data entry. What else could be causing such a high level of manual work in a seemingly streamlined process?
A quick review shows that PCC varies along several dimensions:
1. 19 and 70 percent for financial class
2. 37 and 66 percent for month of service
3. 55 and 59 percent for physician
4. 29 and 70 percent for various CPT codes
Trying to discover a pattern, Dr. Noah looked for a root cause dimension. He drilled into 99213 - the single largest frequency CPT code for his practice. Vericle showed 3,135 claims and the above average 62 PCC carrying charges and payments for 99213 code.
Having isolated the single most frequent CPT code, Dr. Noah was thinking about other dimensions that influence PCC. He hypothesized that if all doctors in his practice had the same coding skills, and assuming uniform distribution of errors, he should observe no PCC variance across the doctors. Yet, a quick click on a Vericle screen yielded a spread, confirming his suspicion that different doctors maintained slightly different coding skills:
1. Dr. Ted 1,554 claims and PCC = 63%
2. Dr. Lori 865 claims and PCC = 62%
3. Dr. Inna 194 claims and PCC = 61%
4. Dr. Noah 516 claims and PCC = 60%
Next, Dr. Noah switched his attention to distribution of PCC across the financial classes. Again, he hypothesized that if all payers used the same rules to deny claims then there should be no difference in the average PCC for different payers, subject to a uniform distribution of errors over a large sample of submitted and paid claims. Yet the numbers showed a significant (30 percent) variation of PCC for the same CPT code: UHC - 82, Blue Cross Blue Shield - 73, Oxford - 64, Aetna - 59, Medicare - 59, and Cigna - 51, confirming his conclusion that various payers used various rules to deny and underpay claims.
Dr. Noah recalled reading an article about PacifiCare, a Californian insurance company being fined upon an audit. The joint Department of Managed Health Care and Insurance Department recently analyzed 1.1 million paid claims from June 2005 to May 2007 that covered about 190,000 members in PacifiCare's HMO plans and PPO coverage [Gilbert Chan , "PacifiCare fined record $3.5 million," www.sacbee.com , January 30, 2008]. They discovered 30 percent of the HMO claims wrongly denied and 29 percent of the disputes with doctors were handled incorrectly. PacifiCare paid out over $1 million and was fined additional $3.5 million. Dr. Noah's findings roughly matched PacifiCare audit - the insurance companies were failing anywhere between twenty to fifty percent of his claims and each insurance company showed a different failure rate, depending on a system used to fail submitted claims.
Finally, Dr. Noah thought of the billing service operation. Is his billing service systematically working to discover failed claims and improve its response to such discoveries? Is there a pattern of an occasional drop of PCC reflecting its deterioration in response to various payer's initiatives? Conversely, is there any evidence for a systematic improvement effort? A chart of the distribution of a single CPT-code clean claim percentage over the entire year must answer his question. In his mind, PCC should iterate between drops and climbs, hopefully each time at a higher level. Vericle confirmed his expectations, showing an overall improvement of PCC over the year (46% 1-07, 39% 2-07, 52% 3-07, 55% 4-07, 63% 5-07, 67% 6-07, 72% 7-07, 69% 8-07, 72% 9-07, 68% 10-07, 74% 11-07, 73% 12-07)
Article Source: http://EzineArticles.com/?expert=Yuval_Lirov
Tuesday, October 7, 2008
Medical Billing and the Discrepancy Paradox of the Rising Healthcare Costs
Health care spending continues to rise at the fastest rate in our history. In 2005, total national health costs rose 6.9 percent -- twice the rate of inflation - reaching $2 trillion, or $6,700 per person [Catlin, Cowan, Heffler, et al, 2006]. Currently, total health care spending represents 16 percent of the gross domestic product (GDP). In the next decade, U.S. health care spending is expected to increase at similar levels, reaching $4 trillion in 2015 [Borger et al, 2006].
While some experts maintain that our health care system is costly because it is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, waste, inappropriate care, and fraud [Health Insurance Cost, National Coalition on Health Care, 2008], at least three remaining key factors, namely, aging population, expensive medical innovation, and defensive care, contribute substantially, to the overall cost picture.
1. Aging population
In the United States, the proportion of the population aged >65 years is projected to increase from 12.4% in 2000 to 19.6% in 2030. The number of persons aged >65 years is expected to increase from approximately 35 million in 2000 to an estimated 71 million in 2030, and the number of persons aged >80 years is expected to increase from 9.3 million in 2000 to 19.5 million in 2030 [Public Health and Aging: Trends in Aging --- United States and Worldwide, 2008; Kaiser Family Foundation, 2006].
"The growing number of older adults increases demands on the public health system and on medical and social services. Chronic diseases, which affect older adults disproportionately, contribute to disability, diminish quality of life, and increased health- and long-term--care costs." [UN, 2002] 125 million Americans have one or more chronic conditions (e.g. congestive heart failure, diabetes.) Chronic diseases account for 75% of all health care expenditures. Source: Burrill & Company, 2006
2. Expensive innovation
* The American biotechnology industry has surpassed pharmaceutical companies for the third straight year as the primary source of new medicines, and biotech revenue jumped nearly 16 percent to a record $50.7 billion in 2005. Source: Ernst & Young LLP, 2006
* The USA is the world's largest and wealthiest pharmaceutical market, accounting for around 48% of the world total. Per capita expenditure on drugs is US $1,069 in 2006, nearly double the level found in the rest of the world. Source: Espicom Business Intelligence, 2006
* ...an estimated 30% of new products under development are "combo products" - involving medical devices embedded with pharmaceutical or biologics components. [Combination Products- Navigating Two FDA Quality Systems, Microtest White Paper, 2007]. The combination products market is estimated at $5.9B in 2004, and will continue to grow at a compound annual rate of 10% through 2009. By 2009, the market is expected to reach approximately $9.5B worldwide with a majority of these revenues from drug-eluting stents and steroid-eluting electrodes. Source: Navigant Consulting, Inc. In 2004, the US held approximately 65% of the drug-device combination product market. By 2010, the US is projected to hold 57%. Source: Business Communications Inc.
3. "Defensive" Medicine
"One of the major cost drivers in the delivery of health care are these junk and frivolous lawsuits. The risk of frivolous litigation drives doctors -- and hear me out on this -- they drive doctors to prescribe drugs and procedures that may not be necessary, just to avoid lawsuits. That's called the defensive practice of medicine.. . . . See, lawsuits not only drive up premiums, which drives up the cost to the patient or the employer of the patient, but lawsuits cause docs to practice medicine in an expensive way in order to protect themselves in the courthouse. The defensive practice of medicine affects the federal budget. The direct cost of liability insurance and the indirect cost from unnecessary medical procedures raise the federal government's health care costs by at least $28 billion a year." [US President George Bush, Arkansas, January 26, 2004]
Now let us observe the paradox:
1. On one hand, the participants of every ancillary industry to health care, including insurance companies, hi-tech and pharmaceutical engineers and scientists, as well as lawyers, have increased their profits in step with the rising costs of health care at ever accelerating pace.
2. On the other hand, the medical and chiropractic office owners - the actual health care providers - have not only failed to keep up with raising costs but have lost a significant part of their income. In fact, between 1995 and 1999, at a time when most wages and salaries in the United States rose 3.5 percent after adjusting for inflation, average physician net income from the practice of medicine, adjusted for inflation, dropped 5 percent [Reed and Ginsburg, 2003]. In 2006, the median compensation for specialty and primary physicians grew only 1.7 ($322,259) and 2 ($171,519) percent respectively, slower than consumer price index of 3.2 percent [MGMA Physician Compensation and Production Survey: 2007 Report]. In comparison, health care costs beat the inflation by 3.5% reaching the annual growth rate of 6.7 [Health Care Spending, 2008]
Diverting our focus away from trying to find solutions to the problem of rising health care costs, we ask a different question: How such a paradoxical situation is possible without a deliberate and systematic strategy against health care providers?
References:
1. Catlin, A, C. Cowan, S. Heffler, et al, "National Health Spending in 2005." Health Affairs 26:1 (2006): 142-153.
2. Borger, C., et al., "Health Spending Projections Through 2015: Changes on the Horizon," Health Affairs Web Exclusive W61: 22 February 2006.
3. Health Insurance Cost, National Coalition on Health Care as of January 4, 2008
4. Public Health and Aging: Trends in Aging --- United States and Worldwide, as of January 4, 2008
5. United Nations. Report of the Second World Assembly on Aging. Madrid, Spain: United Nations, April 8--12, 2002.
6. Kinsella K, Velkoff V. U.S. Census Bureau. An Aging World: 2001. Washington, DC: U.S. Government Printing Office, 2001; series P95/01-1.
7. U.S. Census Bureau. International database. Table 094. Midyear population, by age and sex. 2008
8. The Henry J. Kaiser Family Foundation. Employee Health Benefits: 2006 Annual Survey. 26 September 2006.
9. President Bush Calls for Medical Liability Reform, Baptist Health Medical Center, Little Rock, Arkansas, January 26, 2004 http://www.whitehouse.gov/news/releases/2004/01/20040126-3.html as of January 4, 2008
10. Marie C. Reed, Paul B. Ginsburg, Behind the Times: Physician Income, 1995-99, Data Bulletin No. 24, March 2003
11. Medical Group Management Association (MGMA) Physician Compensation and Production Survey: 2007 Report
12. MEDICARE SPENDING - United States Government Accountability Office (GAO), Testimony Before the Subcommittee on Health, Committee on Energy and Commerce, House of Representatives, March 6, 2007, Healthcare Costs 101
13. Health Care Spending http://www.cms.hhs.gov/NationalHealthExpendData/01_Overview.asp as downloaded on January 15, 2008
Article Source: http://EzineArticles.com/?expert=Yuval_Lirov
While some experts maintain that our health care system is costly because it is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, waste, inappropriate care, and fraud [Health Insurance Cost, National Coalition on Health Care, 2008], at least three remaining key factors, namely, aging population, expensive medical innovation, and defensive care, contribute substantially, to the overall cost picture.
1. Aging population
In the United States, the proportion of the population aged >65 years is projected to increase from 12.4% in 2000 to 19.6% in 2030. The number of persons aged >65 years is expected to increase from approximately 35 million in 2000 to an estimated 71 million in 2030, and the number of persons aged >80 years is expected to increase from 9.3 million in 2000 to 19.5 million in 2030 [Public Health and Aging: Trends in Aging --- United States and Worldwide, 2008; Kaiser Family Foundation, 2006].
"The growing number of older adults increases demands on the public health system and on medical and social services. Chronic diseases, which affect older adults disproportionately, contribute to disability, diminish quality of life, and increased health- and long-term--care costs." [UN, 2002] 125 million Americans have one or more chronic conditions (e.g. congestive heart failure, diabetes.) Chronic diseases account for 75% of all health care expenditures. Source: Burrill & Company, 2006
2. Expensive innovation
* The American biotechnology industry has surpassed pharmaceutical companies for the third straight year as the primary source of new medicines, and biotech revenue jumped nearly 16 percent to a record $50.7 billion in 2005. Source: Ernst & Young LLP, 2006
* The USA is the world's largest and wealthiest pharmaceutical market, accounting for around 48% of the world total. Per capita expenditure on drugs is US $1,069 in 2006, nearly double the level found in the rest of the world. Source: Espicom Business Intelligence, 2006
* ...an estimated 30% of new products under development are "combo products" - involving medical devices embedded with pharmaceutical or biologics components. [Combination Products- Navigating Two FDA Quality Systems, Microtest White Paper, 2007]. The combination products market is estimated at $5.9B in 2004, and will continue to grow at a compound annual rate of 10% through 2009. By 2009, the market is expected to reach approximately $9.5B worldwide with a majority of these revenues from drug-eluting stents and steroid-eluting electrodes. Source: Navigant Consulting, Inc. In 2004, the US held approximately 65% of the drug-device combination product market. By 2010, the US is projected to hold 57%. Source: Business Communications Inc.
3. "Defensive" Medicine
"One of the major cost drivers in the delivery of health care are these junk and frivolous lawsuits. The risk of frivolous litigation drives doctors -- and hear me out on this -- they drive doctors to prescribe drugs and procedures that may not be necessary, just to avoid lawsuits. That's called the defensive practice of medicine.. . . . See, lawsuits not only drive up premiums, which drives up the cost to the patient or the employer of the patient, but lawsuits cause docs to practice medicine in an expensive way in order to protect themselves in the courthouse. The defensive practice of medicine affects the federal budget. The direct cost of liability insurance and the indirect cost from unnecessary medical procedures raise the federal government's health care costs by at least $28 billion a year." [US President George Bush, Arkansas, January 26, 2004]
Now let us observe the paradox:
1. On one hand, the participants of every ancillary industry to health care, including insurance companies, hi-tech and pharmaceutical engineers and scientists, as well as lawyers, have increased their profits in step with the rising costs of health care at ever accelerating pace.
2. On the other hand, the medical and chiropractic office owners - the actual health care providers - have not only failed to keep up with raising costs but have lost a significant part of their income. In fact, between 1995 and 1999, at a time when most wages and salaries in the United States rose 3.5 percent after adjusting for inflation, average physician net income from the practice of medicine, adjusted for inflation, dropped 5 percent [Reed and Ginsburg, 2003]. In 2006, the median compensation for specialty and primary physicians grew only 1.7 ($322,259) and 2 ($171,519) percent respectively, slower than consumer price index of 3.2 percent [MGMA Physician Compensation and Production Survey: 2007 Report]. In comparison, health care costs beat the inflation by 3.5% reaching the annual growth rate of 6.7 [Health Care Spending, 2008]
Diverting our focus away from trying to find solutions to the problem of rising health care costs, we ask a different question: How such a paradoxical situation is possible without a deliberate and systematic strategy against health care providers?
References:
1. Catlin, A, C. Cowan, S. Heffler, et al, "National Health Spending in 2005." Health Affairs 26:1 (2006): 142-153.
2. Borger, C., et al., "Health Spending Projections Through 2015: Changes on the Horizon," Health Affairs Web Exclusive W61: 22 February 2006.
3. Health Insurance Cost, National Coalition on Health Care as of January 4, 2008
4. Public Health and Aging: Trends in Aging --- United States and Worldwide, as of January 4, 2008
5. United Nations. Report of the Second World Assembly on Aging. Madrid, Spain: United Nations, April 8--12, 2002.
6. Kinsella K, Velkoff V. U.S. Census Bureau. An Aging World: 2001. Washington, DC: U.S. Government Printing Office, 2001; series P95/01-1.
7. U.S. Census Bureau. International database. Table 094. Midyear population, by age and sex. 2008
8. The Henry J. Kaiser Family Foundation. Employee Health Benefits: 2006 Annual Survey. 26 September 2006.
9. President Bush Calls for Medical Liability Reform, Baptist Health Medical Center, Little Rock, Arkansas, January 26, 2004 http://www.whitehouse.gov/news/releases/2004/01/20040126-3.html as of January 4, 2008
10. Marie C. Reed, Paul B. Ginsburg, Behind the Times: Physician Income, 1995-99, Data Bulletin No. 24, March 2003
11. Medical Group Management Association (MGMA) Physician Compensation and Production Survey: 2007 Report
12. MEDICARE SPENDING - United States Government Accountability Office (GAO), Testimony Before the Subcommittee on Health, Committee on Energy and Commerce, House of Representatives, March 6, 2007, Healthcare Costs 101
13. Health Care Spending http://www.cms.hhs.gov/NationalHealthExpendData/01_Overview.asp as downloaded on January 15, 2008
Article Source: http://EzineArticles.com/?expert=Yuval_Lirov
Medical Billing Audit - Why Should Providers Audit Payers?
A Sacramento-area surgeon couldn't schedule surgeries for more than six months because his contract was not loaded in the insurer's computer system. More than 200 of Dr. Watson's patients received letters indicating incorrectly that he was no longer participating in the network. Watson lost about 25 percent of these patients and was not paid for about eight months. Another insured spent eleven months trying to get claims paid for his family, including an autistic child. The insurer never specified what information was needed to make the denied claims eligible for payment.
Are these three isolated incidents or are they three symptoms of a growing problem with the entire provider's reimbursement system? The owners of health care practices easily recognize these painfully familiar symptoms. The better questions are: how are they related to the rising healthcare costs and what can a provider do to help?
In 2005, national healthcare costs rose 6.9 percent - twice the rate of inflation, reaching $2 trillion. National healthcare costs are predicted to double to $4 trillion by 2015. While key health care cost factors include aging US population, the arrival of new and expensive drugs and bio-tech devices, and the defensive medicine, the insurance costs alone stand out as a key contributor to rising healthcare costs. Exorbitant executive compensation became a hallmark of healthcare insurance industry, where William McGuire, CEO of UnitedHealth Group, has reportedly received over $500 million since 1992, more than $1 billion worth of options, a lump sum payout of $6.4 million upon leaving the company, and an annual pension of $5.1 million. But such compensation can be easily justified on Wall Street, when comparing it to outstanding insurance industry profits, such as 38 percent growth in earnings in the 3rd quarter of 2006.
The problem for any successful insurance company is how to make such growth sustainable? This question is difficult because the premium growth (68.4 percent) has disproportionally outpaced both inflation (16.4 percent) and workers earnings (18.2 percent) during the same period (2001-2006), making it impossible to continue to rise the premiums without losing major segments of insured population.
Without the ability to attract new clients or to further raise insurance premiums, cost reduction becomes the next most important approach to enhance profitability. Such cost reduction can be done in a variety of ways, which we conveniently divide into strategic and tactical or opportunistic approaches.
Strategic insurer's arsenal
The creation of an oligopsony through consolidation is the main weapon in the strategic arsenal of insurance companies. Oligopsony exists when providers significantly outnumber buyers, enabling them to dictate prices. Take for example, the PacifiCare's $9.2 billion merger with United Health Group Inc. in late 2005, which created a vast network of HMO and PPO plans covering more than 3 million Californians. Today, three plans alone (UnitedHealthcare, WellPoint and Aetna) cover 77.7 million insured lives. Oligopsony allows the systematic and continuous cost reduction without extra investment, e.g., annual cut of allowed rates (such as the average reimbursement for E&M allowable dropped 10 percent in 2006 and another 6.5 percent in 2007), payment suspension for specific procedures (such as EKG tests for routine physicals), offering "all or none" participation alternatives, or the creation of "tiered networks" that profile providers and incentivize patients to see lower cost providers.
Tactical insurer's weapons
Increasing billing process complexity and inventing new denial reasons through arcane terminology, disparate data formats, and modifications of CPT/ICD codes and medical necessity rules - these are all examples of tactical methods designed to increase providers costs for both billing and follow up and reduce the payments at the expense of practice owners. These methods need continuous investment in personnel training, better process management, and improved technology to keep them effective as the providers begin building more sophisticated systems to scrub and analyze claims and discover payment discrepancies and irregularities.
Provider's Response
Returning to the three incidents mentioned at the outset of this article, the joint Department of Managed Health Care and Insurance Department determined that these are not isolated cases. It analyzed 1.1 million paid claims from June 2005 to May 2007 that covered about 190,000 members in PacifiCare's HMO plans and PPO coverage [Gilbert Chan , "PacifiCare fined record $3.5 million," www.sacbee.com , January 30, 2008] and discovered 30 percent of the HMO claims wrongly denied and 29 percent of the disputes with doctors were handled incorrectly. PacifiCare paid out over $1 million and was fined additional $3.5 million.
In summary, providers need new and effective approaches to mobilize both legal and organizational talent to reverse their revenue decline. Legal methods battle market conditions like oligopsony while large-scale medical billing networks aggregate claim volumes and create resulting economies of scale to enable analytical discovery of under-payments.
Article Source: http://EzineArticles.com/?expert=Yuval_Lirov
Are these three isolated incidents or are they three symptoms of a growing problem with the entire provider's reimbursement system? The owners of health care practices easily recognize these painfully familiar symptoms. The better questions are: how are they related to the rising healthcare costs and what can a provider do to help?
In 2005, national healthcare costs rose 6.9 percent - twice the rate of inflation, reaching $2 trillion. National healthcare costs are predicted to double to $4 trillion by 2015. While key health care cost factors include aging US population, the arrival of new and expensive drugs and bio-tech devices, and the defensive medicine, the insurance costs alone stand out as a key contributor to rising healthcare costs. Exorbitant executive compensation became a hallmark of healthcare insurance industry, where William McGuire, CEO of UnitedHealth Group, has reportedly received over $500 million since 1992, more than $1 billion worth of options, a lump sum payout of $6.4 million upon leaving the company, and an annual pension of $5.1 million. But such compensation can be easily justified on Wall Street, when comparing it to outstanding insurance industry profits, such as 38 percent growth in earnings in the 3rd quarter of 2006.
The problem for any successful insurance company is how to make such growth sustainable? This question is difficult because the premium growth (68.4 percent) has disproportionally outpaced both inflation (16.4 percent) and workers earnings (18.2 percent) during the same period (2001-2006), making it impossible to continue to rise the premiums without losing major segments of insured population.
Without the ability to attract new clients or to further raise insurance premiums, cost reduction becomes the next most important approach to enhance profitability. Such cost reduction can be done in a variety of ways, which we conveniently divide into strategic and tactical or opportunistic approaches.
Strategic insurer's arsenal
The creation of an oligopsony through consolidation is the main weapon in the strategic arsenal of insurance companies. Oligopsony exists when providers significantly outnumber buyers, enabling them to dictate prices. Take for example, the PacifiCare's $9.2 billion merger with United Health Group Inc. in late 2005, which created a vast network of HMO and PPO plans covering more than 3 million Californians. Today, three plans alone (UnitedHealthcare, WellPoint and Aetna) cover 77.7 million insured lives. Oligopsony allows the systematic and continuous cost reduction without extra investment, e.g., annual cut of allowed rates (such as the average reimbursement for E&M allowable dropped 10 percent in 2006 and another 6.5 percent in 2007), payment suspension for specific procedures (such as EKG tests for routine physicals), offering "all or none" participation alternatives, or the creation of "tiered networks" that profile providers and incentivize patients to see lower cost providers.
Tactical insurer's weapons
Increasing billing process complexity and inventing new denial reasons through arcane terminology, disparate data formats, and modifications of CPT/ICD codes and medical necessity rules - these are all examples of tactical methods designed to increase providers costs for both billing and follow up and reduce the payments at the expense of practice owners. These methods need continuous investment in personnel training, better process management, and improved technology to keep them effective as the providers begin building more sophisticated systems to scrub and analyze claims and discover payment discrepancies and irregularities.
Provider's Response
Returning to the three incidents mentioned at the outset of this article, the joint Department of Managed Health Care and Insurance Department determined that these are not isolated cases. It analyzed 1.1 million paid claims from June 2005 to May 2007 that covered about 190,000 members in PacifiCare's HMO plans and PPO coverage [Gilbert Chan , "PacifiCare fined record $3.5 million," www.sacbee.com , January 30, 2008] and discovered 30 percent of the HMO claims wrongly denied and 29 percent of the disputes with doctors were handled incorrectly. PacifiCare paid out over $1 million and was fined additional $3.5 million.
In summary, providers need new and effective approaches to mobilize both legal and organizational talent to reverse their revenue decline. Legal methods battle market conditions like oligopsony while large-scale medical billing networks aggregate claim volumes and create resulting economies of scale to enable analytical discovery of under-payments.
Article Source: http://EzineArticles.com/?expert=Yuval_Lirov
Saturday, October 4, 2008
Selecting Medical Billing Services Using Smart Reference Checks
The path from deciding to outsource medical billing to selecting your medical billing company requires a well planned selection strategy. A cornerstone of this strategy is well thought out and executed reference checks.
Reference checking is certainly not the only element that must be properly executed in your medical billing company selection. It is, however, one of the more critical and it has several sub-steps that must be properly considered.
Although today's write-up is geared towards creating an effective interview guide, this is far from the only ingredient of a successful medical billing services company selection. Other critical ingredients include outlining the minimum requirements of an acceptable reference (e.g., does it need to be in your state, what specialties are acceptable, etc), deciding if you want to speak with a former client, outlining the roles of the people with whom your wish to speak (e.g., lead partner, practice administrator, day-to-day billing contact, etc), creating the interview guide, call the references, and making the final go/no-go decision.
Your interview guide will allow you and not the references to determine what topics are addressed in the reference calls. If you do not drive the calls, you may well end the process still unsure about your final decision. To kick-off the interview guide creation think about the worst things and the best things that could happen as a result of medical billing outsourcing. Keeping your mind on these best and worst cases develop questions that will help you determine where between these two extremes your potential medical billing company operates.
It is critical to ensure that your questions are specific enough that you can come away with real facts from the reference calls. You do not want to ask broad questions like "Are you happy with this company's performance?" Such questions are open to much interpretation and are driven by the individual's previous experiences.
Given this issue, your next task is to make the question more geared towards gathering objective facts. For instance, you might change the question above to say, ?How many hours per week did you spend before outsourcing on reviewing billing performance reports, reviewing EOBs, and reconciling your bank deposits with your billing system reports? How many hours per week do you spend on this now??
Once you complete the list of questions and make them specific enough to gather objective data type them out in a logical manner and leave the space required to jot down the answer right on the interview guide. Before the first call sit down and look at the questions one final time. Make sure that the answers to these questions will give you the comfort you need to make a final decision. Start making the reference calls once you are confident your interview guide is ready.
It is your job to make sure you get specific answers to all of all your questions. Think of yourself as a reporter and do not let the call end until you have all of your questions specifically answered. You will need to practice good time management to make sure this happens in the period the person is allowing for the reference call. If you do not get all of your questions answered, then ask to schedule a second call.
You may find that one of your references brings up a point you had not considered. If they do, add the relevant question to the end of your interview guide and call back any individuals with whom you have already spoken to get this additional information.
With your well planned and structured reference checks complete you will be in a position to make an informed medical billing service decision.
Article Directory: http://www.articledashboard.com
Reference checking is certainly not the only element that must be properly executed in your medical billing company selection. It is, however, one of the more critical and it has several sub-steps that must be properly considered.
Although today's write-up is geared towards creating an effective interview guide, this is far from the only ingredient of a successful medical billing services company selection. Other critical ingredients include outlining the minimum requirements of an acceptable reference (e.g., does it need to be in your state, what specialties are acceptable, etc), deciding if you want to speak with a former client, outlining the roles of the people with whom your wish to speak (e.g., lead partner, practice administrator, day-to-day billing contact, etc), creating the interview guide, call the references, and making the final go/no-go decision.
Your interview guide will allow you and not the references to determine what topics are addressed in the reference calls. If you do not drive the calls, you may well end the process still unsure about your final decision. To kick-off the interview guide creation think about the worst things and the best things that could happen as a result of medical billing outsourcing. Keeping your mind on these best and worst cases develop questions that will help you determine where between these two extremes your potential medical billing company operates.
It is critical to ensure that your questions are specific enough that you can come away with real facts from the reference calls. You do not want to ask broad questions like "Are you happy with this company's performance?" Such questions are open to much interpretation and are driven by the individual's previous experiences.
Given this issue, your next task is to make the question more geared towards gathering objective facts. For instance, you might change the question above to say, ?How many hours per week did you spend before outsourcing on reviewing billing performance reports, reviewing EOBs, and reconciling your bank deposits with your billing system reports? How many hours per week do you spend on this now??
Once you complete the list of questions and make them specific enough to gather objective data type them out in a logical manner and leave the space required to jot down the answer right on the interview guide. Before the first call sit down and look at the questions one final time. Make sure that the answers to these questions will give you the comfort you need to make a final decision. Start making the reference calls once you are confident your interview guide is ready.
It is your job to make sure you get specific answers to all of all your questions. Think of yourself as a reporter and do not let the call end until you have all of your questions specifically answered. You will need to practice good time management to make sure this happens in the period the person is allowing for the reference call. If you do not get all of your questions answered, then ask to schedule a second call.
You may find that one of your references brings up a point you had not considered. If they do, add the relevant question to the end of your interview guide and call back any individuals with whom you have already spoken to get this additional information.
With your well planned and structured reference checks complete you will be in a position to make an informed medical billing service decision.
Article Directory: http://www.articledashboard.com
Texas Medical Billing Services
Medical billing is a rapidly expanding field in the healthcare sector, and the demand for skilled medical billing specialists is on the rise. There are many companies now offering medical billing services in Texas in an effective and prompt manner. These companies assist with the tedious tasks of billing and follow-up functions, thus allowing you to concentrate more on your core business.
The process of medical billing involves preparing, submitting as well as following up on insurance claims. The procedures involved in medical billing applications and insurance claims are highly complex. Since most medical office personnel do not have much time to process claims with the insurance companies, they outsource their medical billing assignments to other locations.
Most of the medical billing companies in Texas provide medical billing services to all types of practices and organizations, including physicians’ groups, clinics, hospitals, large healthcare facilities and insurance companies. The companies appoint well trained and highly qualified billing specialists to carry out all the medical billing procedures in an efficient way. They also take care of your insurance details and medical coding processes as part of their services.
Mentioned below are some of the medical billing services provided by medical billing companies:
o Demographic and insurance information
o Insurance verification procedures
o Authorization
o Cash posting
o Charge entry
o Accounts receivable follow up and collections
o Insurance collection
You can enjoy a number of benefits by using the services of a well established medical billing company:
o Electronic processing
o HIPAA compliance
o Complete medical billing management
o Improve your cash flow and collections
o Reduce billing costs
o Reduce payer denials
o Eliminate billing headaches
Before relying on a medical billing firm in Texas, it is better to perform considerable research in terms of rates, services, and other associated factors. As many of the medical billing companies offer free trial version for service quality evaluation, it is an excellent idea to take advantage of those free trial packages.
Article Directory: http://www.articledashboard.com
The process of medical billing involves preparing, submitting as well as following up on insurance claims. The procedures involved in medical billing applications and insurance claims are highly complex. Since most medical office personnel do not have much time to process claims with the insurance companies, they outsource their medical billing assignments to other locations.
Most of the medical billing companies in Texas provide medical billing services to all types of practices and organizations, including physicians’ groups, clinics, hospitals, large healthcare facilities and insurance companies. The companies appoint well trained and highly qualified billing specialists to carry out all the medical billing procedures in an efficient way. They also take care of your insurance details and medical coding processes as part of their services.
Mentioned below are some of the medical billing services provided by medical billing companies:
o Demographic and insurance information
o Insurance verification procedures
o Authorization
o Cash posting
o Charge entry
o Accounts receivable follow up and collections
o Insurance collection
You can enjoy a number of benefits by using the services of a well established medical billing company:
o Electronic processing
o HIPAA compliance
o Complete medical billing management
o Improve your cash flow and collections
o Reduce billing costs
o Reduce payer denials
o Eliminate billing headaches
Before relying on a medical billing firm in Texas, it is better to perform considerable research in terms of rates, services, and other associated factors. As many of the medical billing companies offer free trial version for service quality evaluation, it is an excellent idea to take advantage of those free trial packages.
Article Directory: http://www.articledashboard.com
Outsource Medical Billing - Deciding If It Is Right For You
Over the next several articles I plan to discuss a framework for thinking through whether outsourced medical billing is the right decision for you. The decision is a critical one, so it is imperative that it be based in facts and not in urban legends and myths. Although I am focusing on medical insurance billing services, the basic concepts apply to any outsourcing decision. Today I will outline the main benefits to consider when making the decision about medical insurance billing outsourcing and the most typical concerns and risks associated with the decision to outsource medical billing. Over the following days I will discuss each element in more detail.
The fundamental principal behind outsourcing is the focus on core competencies. The idea is that you and your practice are geared towards treating patients, not fighting insurance companies and pursuing personal balances. On the other hand, medical insurance billing services focus on billing and should have the scale, focus and employees to do a better job than most medical practices or medical facilities. The primary benefits that a medical practice should see from the right medical billing service are:
1. They have more scale to purchase and deploy the technologies required to properly submit claims, battle with insurance companies and collect personal balances.
2. They are able to attract a higher caliber of billing specialists and retain these individuals.
3. They have a deeper bench of employees and this provides a layer of protection for your practice by decoupling you from the risk associated with losing a key (if not the key) billing employee.
4. They are better positioned to properly utilize the technology they have.
5. They have a broader scope than any single medical practice or facility. This allows them to see patterns across practices, specialties, states and payers that can add money to your medical practice's bottom line.
The typical concerns that physicians and practice managers have when deciding whether they want to outsource medical billing are:
1. Will billing services fight as hard for me with insurance companies as my own employees?
2. Can outsourced billing companies handle the unique elements of my practice?
3. Will I lose control and visibility into how my accounts are being worked?
4. Will an outsourced billing company alienate my patients through heavy handed collection practices?
5. Will medical insurance billing services only go after the low hanging fruit, and leave the more difficult money uncollected?
Over the upcoming articles I will go into more depth on each of the benefits and concerns outlined above. I will go ahead and give you a peek at the final chapter. The trick is finding the right insurance billing company. Once you have a company with a proven track record you will be able to see substantial improvements in your practice's revenues have a more attractive bottom line and have more time and energy for your patients, growing your practice and - heaven forbid - a life outside the office.
Article Directory: http://www.articledashboard.com
The fundamental principal behind outsourcing is the focus on core competencies. The idea is that you and your practice are geared towards treating patients, not fighting insurance companies and pursuing personal balances. On the other hand, medical insurance billing services focus on billing and should have the scale, focus and employees to do a better job than most medical practices or medical facilities. The primary benefits that a medical practice should see from the right medical billing service are:
1. They have more scale to purchase and deploy the technologies required to properly submit claims, battle with insurance companies and collect personal balances.
2. They are able to attract a higher caliber of billing specialists and retain these individuals.
3. They have a deeper bench of employees and this provides a layer of protection for your practice by decoupling you from the risk associated with losing a key (if not the key) billing employee.
4. They are better positioned to properly utilize the technology they have.
5. They have a broader scope than any single medical practice or facility. This allows them to see patterns across practices, specialties, states and payers that can add money to your medical practice's bottom line.
The typical concerns that physicians and practice managers have when deciding whether they want to outsource medical billing are:
1. Will billing services fight as hard for me with insurance companies as my own employees?
2. Can outsourced billing companies handle the unique elements of my practice?
3. Will I lose control and visibility into how my accounts are being worked?
4. Will an outsourced billing company alienate my patients through heavy handed collection practices?
5. Will medical insurance billing services only go after the low hanging fruit, and leave the more difficult money uncollected?
Over the upcoming articles I will go into more depth on each of the benefits and concerns outlined above. I will go ahead and give you a peek at the final chapter. The trick is finding the right insurance billing company. Once you have a company with a proven track record you will be able to see substantial improvements in your practice's revenues have a more attractive bottom line and have more time and energy for your patients, growing your practice and - heaven forbid - a life outside the office.
Article Directory: http://www.articledashboard.com
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