When a Medicare patient has multiple sources of insurance coverage, Medicare will only pay for services after the primary payer has processed the claim and made their payment. Medical office staff must always verify the patient's insurance coverage thoroughly - gathering all necessary information from the primary insurance, such as policy numbers, claim submission instructions, and any preauthorization requirements, etc.
Topics: Practice cash flow, payer contract, carrier contract, carrier contract guidelines, medicare compliance, patient billing, claims, insurance
Topics: carrier contract guidelines, medical billing, Medicare fraud, medicare compliance, patient billing
Contract review is a delicate dance but doing your homework and negotiating for a better deal helps to achieve a better outcome, says healthcare attorney, Heidi Kocher, JD, MBA, CHC, of DC-based Law Firm, Liles Parker. Before you start the negotiation process, here are a few things to consider.
Topics: Practice management, contract negotiation, payer contract, carrier contract, value proposition, carrier contract guidelines, Heidi Kocher, medical practice benchmarking
Changes to healthcare delivery, and billing codes during the pandemic, along with major updates to the E/M documentation guidelines have created a ripe environment for government-contracted auditors. But you have the right to challenge auditors. Take steps now to establish your culture of compliance.
Topics: Practice cash flow, payer contract, carrier contract guidelines, medical office, medical billing, financial management, auditing
Elizabeth Daley, MHA, CMIS, CMOM, CMCO, is Director of Client Success at Collect Rx, a 15-year-old company launched by former executives from third-party vendors who pioneered the out-of-network (OON) industry. The company works with 2,100 clients across the country and have built a proprietary database with thousands of claim resolutions at their fingertips to facilitate and expedite the negotiation process.
Topics: Practice cash flow, value proposition, carrier contract guidelines, medical practice issues, medical billing, financial management