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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

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.

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

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.

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 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.

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

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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