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How to Handle the Physician Credentialing Process with Ease

Credentialed physicians

Physician Credentialing – A Necessity

A couple of decades ago healthcare professionals considered physician credentialing as the procedure for enrolment with an insurance company’s preferred provider network.  Now a days, it is mandatory than ever for physicians and healthcare providers including nurses, chiropractors, psychologists, counselors, LCSW’s and many others to be in network with insurance companies. This is a necessity because most people in the United States have health insurance than ever before.  And it is necessary because people today demand their healthcare physicians accept their insurance.  Honestly saying, if a physician is not in network with a patient’s health insurance plan, the provider is at risk of losing that potential patient to a competing practice. (more…)

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Watch for Bundles

Codes used for Percutaneous vertebroplasty include the two procedures frequently performed during the same session—imaging guidance and bone biopsy therefore you might not code individually for them at the same level. 

Codes used for Percutaneous vertebroplasty include the two procedures frequently performed during the same session—imaging guidance and bone biopsy therefore you might not code individually for them at the same level.  If the medical provider performs bone biopsy at a level not addressed by the vertebroplasty, you may report biopsy alone with the 59 modifier appended to indicate the separate locations of the two procedures. (more…)

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Bristol Healthcare Service Transitioned to ICD-10 well Before 2016

At Bristol Healthcare Services, our team of certified coders efficiently managed to transit from ICD-9 to ICD-10 well before the stipulated date. 

October 1, 2016 marked the end of one year that was allowed by the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) to help ease the transition from ICD-9 to ICD-10 for physician practices.

At Bristol Healthcare Services, our team of certified coders efficiently managed to transit from ICD-9 to ICD-10 well before the stipulated date.  Initially we struggled with cardiology coding in E and G codes but very soon managed to submit correct claims. (more…)

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Useful Tips for Successful Contract Negotiation with Payors

Very recently we introduced ancillary healthcare services; including contract negotiation services, to encourage our clients to utilize Credentialing and Contracting services at no extra cost. 

Very recently we introduced ancillary healthcare services; including contract negotiation services, to encourage our clients utilizing Credentialing and Contracting services at no extra cost.  We know “Nothing fits the same for all”. Also, we recommend our physicians to demand their annual report card that lets physicians know how they stand with their peers. (more…)

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Is Medical Billing Outsourcing Advantageous to your Practice?

 medical billing outsourcing being planned

Medical Billing

Medical billing is the process of submitting claims and following up on them with health insurance companies, both federal and commercial, to receive reimbursement for services rendered by a healthcare provider. Medical billing thus translates a medical service into a billing claim. A knowledgeable biller can optimize revenue performance for the practice.

Rules and regulations governing the healthcare industry are updated constantly. The code sets also undergo revisions regularly. Physicians have to devote a large part of their time to overseeing billing and follow-up. This eats into the time needed for quality patient care leading to stress and frustration.

To overcome this scenario, physicians are forced to find a solution to reduce their workload and increase the quality of patient care delivery. (more…)

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Comprehensive Revenue Cycle Management – Getting Paid on Time

Revenue Cycle Management has many stages.

An effective Revenue Cycle Management (RCM) helps practices to increase efficiency and revenues. It also ensures to cut cost and reduce denials considerably. Revenue Cycle Management is not about just one activity, it is all about managing the entire process from start to finish. In the healthcare setting, Revenue Cycle Management begins even prior to a patient’s visit to the facility.

The first step in RCM

Pre-verification or insurance eligibility verification is the first step in Revenue Cycle Management. Here, all the patients scheduled to visit the provider are verified for eligibility and benefits with their insurance. All authorization and referral requirements are clearly understood and documented. Also, Co-pay, Deductibles and out of pocket expenses are documented. The first step to effective Revenue Cycle Management begins with collecting the patient liabilities immediately during the visit. (more…)

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