Reimbursement and chiropractic billing can mostly seem to be simple at one moment, but then become suddenly gets complicated the next. The codes required for billing are recognized by the most chiropractors, but often aren’t complete aware of the complexities and nuances that lead to reimbursement or denial. In this […]
Difference between In-Network and Out-of-Network Benefits
You will get your healthcare at lower costs if the hospital, doctor or health care facility you visit is the part of network of your insurance company. But if in case you go out of your network for healthcare, it can become much more costly. You’ll commonly pay all charges […]
Difference Between Par and Non-Par Providers
This article will let you know about the major differences between participating (par) and non-participating (non-par) providers. Participating (Par) Providers The physicians or other health care providers that have an agreement with a specific insurance payer are known as Participating providers. The terms and conditions of participation for both the […]
Submit an Informal Review for 2017 Physician Quality Reporting System Results through November 30, 2016
In 2017, CMS will apply a downward payment adjustment to those who did not satisfactorily report PQRS in 2015 including: Individual eligible professionals (EPs) Comprehensive Primary Care (CPC) practice sites PQRS group practices Accountable Care Organization (ACO) participant TINs If you have any questions regarding the status of your 2015 […]
Register Now for a CMS Webinar on the Merit-based Incentive Payment System (MIPS)
Learn More about the Merit-based Incentive Payment System and How to “Pick Your Pace” in 2017 The Centers for Medicare & Medicaid Services (CMS) invites you to join a webinar on November 29 at 1:30 PM ET on the Merit-based Incentive Payment System (MIPS). By joining you will gain more […]
How CLIA affects my reimbursements?
CLIA is important when you are rendering CLIA waived services to the patients. If you don’t have CLIA Certificate with you. The Insurance will not be able to pay you for CLIA waived services. Also Read: Clinical Laboratory Improvement Amendments (CLIA)
Clinical Laboratory Improvement Amendments (CLIA)
Health care providers are helped by diagnostic testing to screen for or monitor particular diseases or conditions. It also helps assess patient health to make clinical decisions for patient care. The laboratory testing and require clinical laboratories is regulated by Clinical Laboratory Improvement Amendments (CLIA) to be certificated by their […]
If a Rendering Provider terminates his/her services to group, how can we still get paid for the services provided by different providers within the Group?
This is a common question that most of the providers ask. Many of Group Owners are reluctant to know that if the provider has terminated his/her services to the group than, how they’ll get the reimbursements for the patients? You need to keep in mind that, every individual provider within […]
I’ve recently purchased established Medical Practice. Can I submit the claims to the Insurances from the first day as an In-Network?
There are two different situations to submit the claims to the Insurances. Submitting Claims under the Established Tax ID If you are submitting the claims under the same Tax ID and same Providers are working under the Group, you can submit the claims to the Insurances. For the provider’s addition […]
As an Out of Network Can we bill to the Insurances?
Yes, we can bill to the insurances but the Insurances will entertain the claims as an Out of Network. For such patients who are Out of Network, practice should first inquire Out-of-Network benefits from patient’s insurance and explain the situation to the patient. If patient agree to pay. You can […]