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Articles from Jacob Thomas | Selfgrowth.com
- Alleviating the Time Factor in Evaluating Revenue Generation from Medical Claims - by Submitted on Oct 24, 2011 from Jacob Thomas“While physicians would not mind investing in revenue optimizing systems, asking them to invest their invaluable time in something which is non-core to their medical efficiency could ultimately have an adverse impact on their efficiency for medical care. Therefore, there seems to be a ...
Views: 733 - Appealing Denied Insurance Claims: An Overview - by Submitted on Oct 05, 2011 from Jacob ThomasThe process of appealing a denied insurance claim is complicated but can be effective if done correctly since there are numerous reasons for claims to be denied by an insurance company. The payer or insurance company receives thousands of claims everyday and the claim can be quickly denied if ...
Views: 632 - Are You Prepared to Deal with Patient Information Breach? - by Submitted on Oct 04, 2011 from Jacob Thomas‘The readily available sources for implementing security-rich technology platforms should not only make your search easier but also ensure Patient Privacy Compliance by sage-guarding critical information against undesirable proliferation, and sharing information only at the behest of ...
Views: 590 - Assess the capability of your workforce: Is your clinic administration in the right hands? - by Submitted on Aug 02, 2011 from Jacob ThomasThe capability of your workforce as a physician is directly impacted by the number of people you hire and the efficiency of the staff. Ideally every business entity needs to find the right balance between the number of people employed and the profits or revenue that they help generate. This ...
Views: 585 - Better Payer Interaction for Physicians - by Submitted on Nov 03, 2011 from Jacob ThomasPayer interaction plays a crucial role in ensuring that physicians receive payments in a fair and timely manner. Medical billers and coders who interact with payers need to stay current with major payers (insurance companies, employers, or the government) in order to make sure that errors and ...
Views: 584 - Bundled payment initiative to lower healthcare costs, help coordinate care - by Submitted on Sep 12, 2011 from Jacob ThomasA new program to aid and improve patient care while patients are in the hospital and after they are discharged has been announced by the U.S. department of Health and Human Services (HHS). These initiatives will also motivate doctors, nurses and specialist to perform coordinated care and hence ...
Views: 552 - CMS encouraging physicians for health care reform innovation: grants offered - by Submitted on Jan 10, 2012 from Jacob ThomasAt last someone is looking to cut healthcare cost innovatively- The Health Care Innovation Challenge program, announced on 14th November, last year is the most recent federal effort by the Center for Medicare and Medicaid Innovation (CMMI) to support health care innovations. The program is aimed ...
Views: 578 - CMS to delay enforcing 5010 compliance - by Submitted on Nov 30, 2011 from Jacob ThomasCenter of Medicare and Medicaid announced that it will delay enforcing HIPAA 5010 transaction sets requiring hospitals, physician practices, health plans and claims clearinghouses to switch to using the ASC X12 Version 5010 standards for the electronic transmission of healthcare claims and ...
Views: 613 - Combating Healthcare Fraud and Abuse – a challenging task for providers - by Submitted on Oct 03, 2011 from Jacob ThomasThe inherent nature of Health Insurance is such that it is highly susceptible to fraud and abuse by unscrupulous healthcare providers and beneficiaries. Consequently, there has been an unbridled rate of fraud and abuse amounting to billions of dollars – a reliable statistics puts it around 300 ...
Views: 669 - Dealing with overpayments in your practice - by Submitted on Dec 06, 2011 from Jacob Thomas“Simple it might seem, yet given the time and the resources that such monitoring and reporting eventually consumes, physician practices can find it hard to take up such intensive scrutiny amidst the overriding challenge of keeping their medical service quality benchmarked to the perennially ...
Views: 609 - Deciphering Medicare Fee Schedules - by Submitted on Oct 19, 2011 from Jacob ThomasA proactive affinity to Medicare Fee Schedule alerts physicians to the efficacy of attending to Medicare beneficiaries, and also plans their revenue prospects in advance. But, with the legislation firm on mandatory medical service to Medicare patients, physicians are inevitably driven to seek ...
Views: 584 - Demand for primary care doctors peaks - by Submitted on Sep 12, 2011 from Jacob ThomasAccording to a survey, need is driving the demand for primary care physicians; listed below are the major reasons for this increased demand: •Many healthcare groups are in the process of forming patient-centered medical homes (PCMH), ACOs, and various other employment models which have ...
Views: 451 - Dermatologists’ Shortage in the US – a medical billing perspective - by Submitted on Dec 05, 2011 from Jacob ThomasContrary to mounting demand, US healthcare industry continues to be plagued by shortage of dermatologists – the physician-patient ratio has grown to be so unhealthy that patients have to wait as long as 38 days just to have an appointment with their physicians; there have even been extreme cases ...
Views: 1186 - Doctors contemplate opting out due to continued Medicare hassles - by Submitted on Dec 23, 2011 from Jacob ThomasPhysician participating in the Medicare program are scheduled to face a 27.4% cut in their payments, effective 1st January, 2012, and with providers anyway complaining about current reimbursement rates, the cut is likely to considerably impact both patients as well as doctors adversely. As a ...
Views: 639 - Effective patient care versus revenue cycle management: physicians perform a balancing act - by Submitted on Aug 18, 2011 from Jacob ThomasPhysicians in the U.S., despite ranking high for their medical competence, have never been able to fully realize and optimize their medical bill reimbursements owing to an increasingly complex health insurance system that has been constantly evolving, and characterized by: • HIPAA Compliant ...
Views: 1043 - Evaluating the Procedural Constituents of Medical Claim Management Cycle - by Submitted on Dec 02, 2011 from Jacob ThomasGiven the alarming statistics about medical billing industry average – 14% of all claims submitted to the payers are denied and have to be resubmitted, appealed or written off by providers, 50% of denied claims are never re-filed, and 50-70% of denied claims have higher chance of being recovered ...
Views: 620 - Fall in doctor office visits by patients under 65 - by Submitted on Jan 11, 2012 from Jacob ThomasUS physicians recently have been experiencing a gradual decrease in visits by privately insured patients younger than 65. IMS Institute for Healthcare Informatics, a health care research firm tracked an overall 4% drop in patient visits in 2011 compared with 2010, and Thomson Reuters Healthcare ...
Views: 572 - Gearing Up for Inpatient Medical Coding and Reimbursement Challenges - by Submitted on Oct 28, 2011 from Jacob Thomas“The prevalence of such demanding challenges is reason enough to push physicians beyond their Medical Billing Management capabilities, which invariably results in compromised medical efficiency. Therefore, physicians – faced with insurmountable challenges of inpatient medical billing management ...
Views: 781 - Group Appointments A new niche for Primary Care Practice - by Submitted on Oct 24, 2011 from Jacob ThomasGroup appointment, also referred to as shared medical appointment, includes multiple patients seen as a group for follow-up or routine care. These visits are voluntary for patients and provide a secure but interactive setting in which patients have: improved access to their physicians, the ...
Views: 561 - Hospitalists registered a pay increase in 2010 - by Submitted on Oct 13, 2011 from Jacob ThomasThe year 2010 has registered a hike in the median compensation for Hospitalists. The Hospitalists in adult medicine saw their compensation increase 2.6% to $220,619 from $215,000 while the Pediatric Hospitalists’ pay rose by 7.2% to $171,617. The report, which is based on MGMA survey ...
Views: 583 - How to Find the Best Medical Billing Specialist in your area - by Submitted on Jun 24, 2011 from Jacob ThomasOne may ask why practices require medical billing specialists. A crucial reason might be that taking up the services of a medical biller or a coder may lower overhead costs and expenses but definitely will help the physician to collect more revenues. Physicians across all states are constantly ...
Views: 566 - ICD-10 Implementation: An update for physicians and coders - by Submitted on Aug 09, 2011 from Jacob ThomasThe transition to ICD-10 is much more than a mere increase in codes and field sizes. The descriptions of diagnosis codes in ICD-10 may be very different to what coders are used to seeing and using in ICD-9. Therefore, the complexity in transition is significant and shouldn’t be avoided by ...
Views: 474 - Impact of Federal Debt Ceiling on Medicare Payments to Physicians - by Submitted on Aug 31, 2011 from Jacob ThomasAlthough there have been instances in the past that allowed for raising debts well over the statutory limit, yet the present scenario is such that it has put a question mark over the Federal Government’s ability to borrow. Consequently, despite the talk of an additional $2.2 trillion borrowing ...
Views: 471 - Increased inaccuracy in claims payments by health insurers - by Submitted on Jul 18, 2011 from Jacob ThomasAMA (American Medical Association) has released its Fourth Annual National Health Insurer Report Card which underscores the 2% increase in inaccurate claim payments since last year among the leading commercial health insurers. Claims-processing errors by health insurance companies squander ...
Views: 459 - Increasing Demand for Certified Coders in Healthcare - by Submitted on Sep 26, 2011 from Jacob ThomasThe year 2010 has set a premium on the coding professionals, registering a rise in their average salaries. And as expected, the salaries for certified medical coders are higher as compared to the non certified ones. According to a salary survey of nearly 12000 coding professionals, the ...
Views: 611 - Increasing trend in Hospital Employment: Impact Physician Billing - by Submitted on Dec 28, 2011 from Jacob ThomasHealth care reform, widely anticipated federal Medicare reimbursement cuts and a variety of changes in the physician workforce, are fuelling more and more physicians to move under the hospital’s umbrella. Hospitals employees are expected to increase in the next ten years considerably with 85% of ...
Views: 617 - Is ICD-10 Transition Feasible by October, 2013 Deadline? - by Submitted on Sep 06, 2011 from Jacob ThomasAs we stand at the mid of the intervening period, there is growing apprehension over achieving comprehensive realization of ICD-10 and other Compliance standard implementation by the October 1, 2013 deadline across the spectrum of healthcare stake-holding: health care providers, payers, software ...
Views: 445 - Is Outsourcing Medical Billing Services More Viable than In-house Practices? - by Submitted on Nov 09, 2011 from Jacob Thomas“Although, in-house medical billing, owing to its proximity to the physician’s supervision, can work relate itself better than the outsourced solutions, yet, it is beset with inherent adequacies” Although physicians practices have equally been divided between in-house medical billing and ...
Views: 1382 - Level of Preparedness for Smooth Transition to ICD-10 - by Submitted on Aug 12, 2011 from Jacob ThomasUS Federal Government, which has earmarked October 1, 2013 as the deadline, has sought to replace the 30-year-old ICD-9 with the radical ICD-10 – believed to be harbinger of sweeping changes across all facets of healthcare organizations: providers, staff, processes, insurance carriers, and ...
Views: 510 - Meaningful Use completed its one year How far has your practice reached - by Submitted on Aug 05, 2011 from Jacob ThomasAdopting these health care IT reforms can assist physicians to provide quality care and increase their revenue by making the process of payment quicker and by avoiding preventable errors. However, the incentives offered for implementation of EHR can differ according to when the EHR are adopted ...
Views: 426 - Meaningful Use’ Compliant EHR Technology Implementation – specialists’ perspective - by Submitted on Jan 20, 2012 from Jacob Thomas“While specialist practitioners, such as Radiologists, Psychiatrists, Chiropractors, Urologists, etc. can claim exemptions and exclusion of certain objectives set out in the Meaningful Use Clause by CMS, they are not treated preferentially as far as documenting clinical processes using approved ...
Views: 760 - Medicaid claims audits slated for January - by Submitted on Oct 11, 2011 from Jacob ThomasThe Medicaid recovery Audit program is due to get implemented nationwide in January, carrying on in a similar vein as Medicare RAC program, as announced by CMS on 14th September, 2011. The Medicare RAC had recovered $451.3 million in overpayments and corrected $78.5 million in underpayment ...
Views: 619 - Medical Billing - 10 Blunders to avoid - by Submitted on Jul 01, 2011 from Jacob ThomasSince the past few years, medical practices have seen stagnancy or declining medical reimbursements especially with the continuous rise in practice costs. Most practices are unable to understand the core reasons for dipping revenues and increasing denials. Expert billers and Coders have ...
Views: 669 - Medicare Cuts and Geriatric Medicine - by Submitted on Nov 03, 2011 from Jacob ThomasThe proposed Medicare cuts by President Obama and the Congressional “Super Committee” does not bode well for physicians and geriatric medicine in the country. Although the cuts would ensure that Medicare bankruptcy would be postponed and the Federal deficit reduced, it has long term negative ...
Views: 655 - Medicare learning network Updates Medicare Claim Submission Guidelines - by Submitted on Nov 01, 2011 from Jacob ThomasCenter of Medicare and Medicaid services has released fact sheet on Medicare claim submission guidelines. The fact sheet offers billers, coders and physicians up-to-date guidance on how to file Medicare Claims. Following are some important points mentioned in the fact sheet: Browse all: ...
Views: 696 - Ohio tops in EHR usage, with the other states catching up - by Submitted on Jan 09, 2012 from Jacob ThomasAccording to Ohio Health Information Partnership, around 6,750 doctors in Ohio, the maximum count of physicians compared to any other state, have committed to electronic health records (EHR), leading the nation in usage of EHR’s. Greater Cincinnati has nearly 985 physicians who have committed to ...
Views: 611 - Optimizing Revenue By PQRS Participation - by Submitted on Aug 30, 2011 from Jacob ThomasPQRS, the Medicare program paid out over 234 million US dollars in 2009 to medical professionals who subscribed to the program. However, a large segment of professionals failed to qualify, were just not aware, or lacked the inclination to take part. Out of over one million medical professionals ...
Views: 466 - Outsourced Medical Billing – the prescription for new practices’ impressive ROI - by Submitted on Aug 11, 2011 from Jacob ThomasGiven the rapidly expanding patient base, and an insatiable demand for quality medical care, it is not surprising that each passing-by moment is witness to the birth of a new practice. Despite being driven by a larger healthcare vision, new practices – operating in a market-driven environment – ...
Views: 587 - Paid-sick-days concept as a preventive option for Federal healthcare expenditure - by Submitted on Jan 12, 2012 from Jacob Thomas“Coming at a time when Federal Government itself is promulgating radical healthcare reforms to tackle growing medical expenditure on public healthcare, and promote efficient and quality medical care to its ever growing insured population, this paid-sick-days concept promises to complement the ...
Views: 583 - PCMH Assisting Primary Care Physicians as well as Patients - by Submitted on Aug 26, 2011 from Jacob ThomasPCMHs employ the latest technology available to make optimum use of time and funds in order to deliver best possible healthcare to the patients. Although the concept is not new it has gained recognition and popularity among patients and physicians alike due to the recent health reforms. There ...
Views: 502 - Physicians see value in handling Claim Denials in a Better Way - by Submitted on Oct 31, 2011 from Jacob ThomasAppealing denied claims is one of the important steps in enhancing the revenue of physicians and this fact is supported by a report by the U.S Government Accountability office (GAO). The report released on March 16, 2011 states that – “coverage denials occurred for a variety of reasons, ...
Views: 620 - Physicians tackle HIPAA requirements and increased scrutiny by Government - by Submitted on May 23, 2012 from Jacob ThomasThe health reforms have not only affected the way in which healthcare is delivered but also the way in which information is shared among various professionals and entities in the health industry. Health Insurance Portability and Accountability Act (HIPAA) regulations have become more stringent ...
Views: 726 - Physicians to make the most of 5010 Enforcement Delay - by Submitted on Dec 27, 2011 from Jacob ThomasPhysicians were mainly relieved with the announcement made by Centers for Medicare & Medicaid Services (CMS) Office of E-health Standards and Services (OESS) on 17th November, to delay enforcement of Health Insurance Portability and Accountability Act HIPAA 5010 transaction standards with a ...
Views: 609 - Predicting the scope of medical billing consultants after 2014 and beyond - by Submitted on May 24, 2012 from Jacob ThomasAlthough it has been quite a while since the Federal Government announced a series of far-reaching healthcare reforms, we are yet to experience their full impact across the healthcare continuum. And, with the Senate bill deferring a major chunk of the reforms further, it is expected that we may ...
Views: 574 - Primary Healthcare: A Critical Reassessment in the Changing Healthcare Scenario - by Submitted on Aug 18, 2011 from Jacob ThomasThe Primary Health Care (PHC) system in the US has so far served as a platform for providing frontline care with services provided by medical professionals ranging from family physicians and assistants, internal medicine specialists, nursing practitioners and clinicians. However, the ...
Views: 857 - Redefining the Role of Billers and Coders in the Wake of Ensuing Accountable Care Organization Act - by Submitted on Jul 26, 2011 from Jacob ThomasIt is mandatory that a consenting group of medical professionals – comprising physicians, specialists, and support staff —form an alliance that caters to comprehensive needs of the pre-assigned group of patients while also keeping the standard high. Thus, all along with having incentive to a ...
Views: 477 - Revenue Cycle Improvements for Physicians and Clinics: An Overview - by Submitted on Dec 12, 2011 from Jacob ThomasThe revenue cycle management process starts even before the patient visits a physician’s office or a clinic or hospital and ends when full reimbursement is realized. The scope for improvements in the revenue cycle management process has been accentuated in the recent times due to changes in the ...
Views: 615 - Revenue Cycle Management – prescription for optimum medical claim realization - by Submitted on Oct 10, 2011 from Jacob Thomas“Despite such volatile environment, physicians have to find means to realize their each and every dollar owed them as their very sustenance and growth hinges on efficient reimbursement of medical bills” Unlike other professional services that realize their professional fees instantly, without ...
Views: 1115 - Rural Healthcare Becoming a Lucrative Business - by Submitted on Jul 04, 2011 from Jacob ThomasRecently, Texas has lifted a ban on prohibiting rural hospitals from employing physicians in order to solve the problem of shortages of doctors and health care providers in states such as Texas and California. However, it remains to be seen whether the recent healthcare reform would have some ...
Views: 417 - Salary survey 2011 for coders - by Submitted on Nov 01, 2011 from Jacob ThomasSalary survey for coders is out for year 2011. The survey is carried out amongst 12,000 respondents; the survey clearly shows an upward trend in average salaries for coders. The survey has also brought out some key trends in coders hiring, region wise average salaries and various career paths ...
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