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6 Most Important Medical Billing Reports

Ensuring that your practice is functioning efficiently involves investigating many things. One of the parts of your practice that needs to be working smoothly is your billing process. Medical billing reports are an important way to learn about this. They can give you vital information about claims, payments, and a variety of other aspects of your practice. Though there is a wide array of reports you should be checking for your practice, some should take priority over others. Following are 6 of the most important medical billing reports that your practice should check frequently. The Accounts Receivable Aging Report The

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UnitedHealthcare Accused of Wrongfully Denying Over $11 Million in Claims

NYC Health + Hospitals and UnitedHealthcare are set to enter arbitration regarding $11.5 million in denied inpatient medical claims. These claims are all related to patients who sought emergency department treatment between July 2014 and December 2017. The patients were covered by UnitedHealthcare’s Medicaid and Medicare programs. Their claims through Medicare and Medicaid for emergency treatment were denied, leading to NYC Health + Hospitals’ arbitration pursuit. None of the denied claims werefor cases of ambulatory care, behavioral health, or other services. NYC Health + Hospitals believes that the claims were wrongfully denied. Since the claims were all related to emergency

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What You Need to Know About Claims Scrubbing

The speed at which medical claims are processed is a vital part of the medical billing process in the United States. If the claim goes through quickly, it can save the patient, provider, and insurer time, money, and frustration. This is where we enter claims scrubbing into the equation. Thorough claims scrubbing is a significant step that will determine whether the claim goes through the first time or not. Whether you are seeking or providing healthcare, it is important to understand what claims scrubbing is and how it factors into the medical billing process. What Is Claims Scrubbing? Many steps

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Medical Bills: The Leading Cause of Bankruptcy in the United States

Debt is a huge problem in the United States. Whether it is from paying for school or buying a home, a large portion of American citizens owe some amount of money. Unfortunately, medical expenses are one of the reasons some people fall into debt. In 2017, and in many previous years, medical bills were the leading cause of bankruptcy in the United States. The federal laws around healthcare have shifting every year, but bankruptcy is still a serious issue. Medical Debt in the United States Medical debt has been the leading cause of American bankruptcy for years. In 2013, a

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The Growing Trend of Outsourced Medical Billing

Many medical clinics have already made the change from in-house medical billing to outsourced billing. At this point, there are no clear-cut deciding factors of which method is best. Medical billing operations rely heavily on the needs of individual clinics and physicians. Finding the right answer for your business involves analyzing needs and taking inventory of factors you consider to be important. The Trend Toward Outsourcing The expansion of technology and IT resources has allowed the field of medical billing to expand virtually. Outsourcing and third-party billing providers are now an option available for local or virtual positions. In addition,

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Medicaid Revealed to be Most Complex Insurer in Country

A recent study published by Health Affairs has proven what we all know to be true: Fee-for-service Medicaid is the most difficult insurer to bill. The study, conducted by economists, revealed a claim denial rate 17.8% higher than other insurers. The result is an increase in administrative and labor costs, but also a situation that creates problems for providers. Medicaid has long been plagued by billing problems, and there doesn’t seem to be an end in sight. Number Crunching Fee-for- service Medicaid claims are denied at a rate of 18%, 10.7% higher than Medicare denials. For private insurers, Medicaid claim

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Zika Virus and Medical Billing

Zika virus is spread by infected mosquitoes, and a vaccine has not yet been developed to treat it completely. Symptoms often mimic those of other ailments and diseases, so it can be difficult formedical professionals to diagnose. The virus is especially dangerous when infected insects sting pregnant women and mothers pass the virus on to their unborn child. Infection during pregnancy can cause birth defects. Healthcare providers not only face the challenge of treating patients who show symptoms, they also must adhere to regulations for coding and reporting. What Is the Zika Virus? The Zika virus was first discovered in

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Shocking Number of Providers Still Use Paper Billing

A Navicure survey reveals even though more than half of patients prefer electronic medical bills, 77 percent of providers still send bills through the mail. Researchers also found while only 28 percent of providers keep a patient’s credit card on file to make paying easier, the number of patients who would be willing to use such methods is much higher. Electronic medical billing is a faster, easier way to deal with medical billing. Computerizing medical bills and billing records have many benefits that affect healthcare providers and patients. Eliminates Hassle Paper medical billing creates a large amount of hassle for

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Hospitals Say Regulatory Compliance Drives Up Annual Costs

The American Hospital Association (AHA) reports hospitals and healthcare providers spend more than $39 billion annually on tasks related to compliance issues. Investing in technology, training, and staff allows them to keep up with demands, but causes them to feel overworked and pressured to meet continually rising requirements. Just last year, providers saw 629 changes in nine domains related to reporting, meaningful use, billing and other administrative tasks. There are 4 groups involved in creating legislation: CMS, OIG, OCR, and ONC. Centers for Medicare & Medicaid Services (CMS) The Centers for Medicare & Medicaid Services (CMS) is a part of

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Does EHR Adoption Really Lower Administrative Costs?

The government mandated adoption of electronic health records (EHR) systems claims the change improves patient care and reduces costs for healthcare providers. Healthcare providers adopted systems in stages to meet the requirement, hoping costly implementation would eventually pay off. Many facilities aren’t seeing the benefits they’d hoped for. The results are leaving many providers skeptical of the claim that EHR truly lowers administrative costs. What Are Electronic Health Records? Electronic Health Records (EHRs) are digital versions of a doctor or hospital patient’s paper chart. The goal of EHRs is to remove the need for physical documents to keep track of

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2018 Healthcare Trends

Healthcare is a hotly contested subject within government, and the conversation has been shifting for decades. The last few years change has rapidly accelerated with new legislation, changes to the way insurance provides payment, fresh hope for chronic disease and a rapidly evolving approach to patient care. Let’s take a brief look at what happened last year to create such sweeping change and discover what patients and providers can expect in 2018. The Opioid Crisis Takes Center Stage Opioid overdoses have quadrupled since 2000, making the opioid crisis a key focus for government and healthcare officials in the year ahead.

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What Makes the Highest-Rated Medical Practice Management Software?

There’s a lot more to running a medical practice than just treating patients. Physicians and administrators balance human resources and ever-changing regulations. They make daily decisions that involve vendor relationships and revenue streams. Technology can make many aspects of healthcare easier with claims processing software and systems that coordinate aspects of patient care. However, many physicians find themselves juggling different systems for scheduling, reporting and billing, and it bogs down office processes. Find out how medical practice management software can help, how it relates to your clearinghouse and how to choose the best for your facility. What Is Medical Practice

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Speedy Claims : Why Are They So Important?

One of the most significant traits of claims processing is how fast it can all happen. If a claim is processed quickly it can be less expensive and your customer satisfaction will skyrocket. Find out why speed is so important and how to make sure you don’t lose a second when it comes to receiving payment. The Claims Process It should be so simple. Your practice provides a patient with treatment. They give you their insurance information. You supply the insurance company with a request for payment. It seems reasonable that they should process and approve your claim. However, each

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Why Was My Claim Returned?

When medical billers complete claims correctly, the payer reimburses the medical provider for services. However, any time human beings enter data, there’s a potential for error. The more information they must enter, the greater the chance something might be missed along the way. Medical claims processing involves both information vital to the patient receiving needed medical care and data necessary to the healthcare provider getting paid. While a returned claim can still be resubmitted, it’s much simpler to get it right the first time. Here we’ll review the most common reasons claims are returned and suggest ways to keep it

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Common Medical Billing Mistakes That Affect Customer Service (and How You Can Fix Them)

No one likes receiving medical bills, because they often contain unwelcome surprises. If your billing department receives frequent phone calls for overbilling, your practice might be guilty of one – or more – of these behaviors that lead to customer dissatisfaction and decreased billing productivity. Medical claims processing is a critical part of a practice, and claims processing software can help keep patients happy and ensure there are no delays in clearing the medical billing clearinghouse. Make your billing department run smoothly by avoiding these mistakes. How Big a Problem Are Medical Errors? The Department of Health and Human Services

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