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Payers

How to Work With New Reform-created Patients

To survive a potential influx of patients from healthcare exchanges, practices must focus on a few key areas, experts say. Communicate with patients; monitor payer mix; and manage billing and collections.

ALSO: Our 2014 PayerView data, by athenahealth, provides insight on how easy or hard it is for your practice to work with payers.

Payers

Five Steps to Easy Physician Credentialing

Lucien W. Roberts
Pearl | July 23, 2014 | Payers, Healthcare Careers, Managers Administrators, Pearls, Recruitment
By

Done haphazardly or postponed until a month before a new physician starts, sloppy credentialing can spell cash-flow delays and more. Here's how to do it right.

5 Common Medical Practice Denials and Remedies: May 2014

July 11, 2014 | Medical Billing & Collections, Coding, Denials, Payers, Revenue Cycle Management

RemitDATA's vice president of product management, Aaron Hood, explores the most common unexpected denials at practices nationwide, with a focus on radiology.

Diagnosis Coding: Why It Is So Important

Betsy Nicoletti
Pearl | July 02, 2014 | Coding, ICD-9, Payers, Pearls
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Claims are paid based on the CPT code submitted to the payer. The diagnosis code supports medical necessity and tells the payer why the service was performed.

Progress Traps and the 340B Drug Pricing Program

Martin Merritt
Blog, News | June 29, 2014 | Law & Malpractice, Operations, Patient Relations, Payers
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Hospitals are not only marking up and selling 340B-discounted drugs, but also buying up clinics to take advantage of the discount – a clear "progress trap."

The Independent Physician’s Dystopian Future

James Doulgeris
Blog | June 26, 2014 | Healthcare Reform, Payers, Physician Compensation, Practice Models
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The near future for physicians: Dying mom and pop store owners in a big-box health plan, hospital system world trading lab coats for a branded apron.

Health Insurance Fine Print Shifts Burdens to Physicians

Martin Merritt
Blog | June 22, 2014 | Audits, Healthcare Reform, Payers
By

Payers can no longer exclude patients due to pre-existing conditions, so they are resorting to other tactics.

Medical Practice Collections Efforts Just Became Easier

P.J. Cloud-Moulds
Blog | June 14, 2014 | Medical Billing & Collections, Payers
By

When patients refuse to pay their cost-share for healthcare, you have a surprise go-to resource to help get you paid.

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