Credentialing tools

Credentialing Tools: Checklists and Programs to Speed Applications

Timely, accurate credentialing is imperative for a practitioner to see patients, bill insurance, and have hospital privileges.   Because this can be a lengthy process with a lot of information to manage, your success often hinges on the caliber of the credentialing tools you use. Credentialing is a complex process. With varying requirements between payers, mounds […]

Bust 3 Myths to Boost Pay for Your Fee-for-Compensation Physicians

Are you billing for fee-for-compensation services correctly? Many practices aren’t — and that means leaving money on the table. In today’s healthcare market, that’s not something you can afford to do. Unfortunately, fee-for-compensation billing is often misunderstood, so many practices aren’t getting all the reimbursement they deserve. Plus, incorrect or non-compliant billing practices can catch […]
medical collections front desk helping patient

5 Tips to Prevent Unpaid Medical Collections – Supercharge Your Staff

For years, deductibles were so low. Payers paid most of the patient responsibility on claim submission. Those days are obviously gone putting the onus on your practice’s medical collections to keep your revenue stream healthy. “Most patients maybe had a $250 or $500 deductible,” recalls medical collections expert Tracy Bird, FACMPE, CPC, CPMA, CEMC, CPC-I, […]
provider credentialing

New Provider Credentialing: Your Top 10 Questions — Answered!

Does even thinking about new provider credentialing give you a headache? Sure, you’re anxious for new providers to start generating revenue for your practice. But you’re also dreading those long, complicated forms that are so easy to mess up. Credentialing is anything but simple. One misstep, and your practice’s revenue cycle will slow to a […]
Claim form errors

Best Practices to Avoid Costly Claim Form Errors

Everyone makes mistakes. Unfortunately, sometimes small mistakes will cost you big time. Such is the case with claim form errors. The CMS form 1500 is your primary means of getting reimbursement from Medicaid, Medicare, and Tricare. Even a minor claim form error can delay processing and payment or worse—lead to denial. On the flip side, […]
Medical coding and billing

What Type of Education Is Needed for Medical Billing and Coding?

Pursuing a career in medical billing and coding can be one of the most rewarding experiences in your life. This is a serious and complex field that is becoming more and more competitive. You don’t have to be a doctor or a nurse to help thousands of patients, because you can contribute quite a lot […]
Modifier 59 Separate Is Key

Solve Your 5 Biggest Modifier 59 Problems by Focusing on ‘Separate’

If you’re using Modifier 59 to get paid for multiple procedures, auditors are watching you. Modifier 59 has been on the OIG’s (Office of the Inspector General) radar for a while now, and because of consistent misuse and abuse, it will likely stay that way. Modifier 59 allows you to unbundle — separately report and […]
Medical Credentialing Doctor With Credentials

Medical Credentialing: What Is It & Why Is It Important for Reimbursement?

Without proper medical credentialing, a medical practitioner legally cannot work at a hospital or partner with insurers. Having medical staff credentialing training is crucial to ensure a new physician or practitioner is allowed to see patients, receive insurance reimbursements, and hospital privileges. Fail to attain on-time credentialing and the new staff will fail to meet […]
abn form

Medicare’s ABN Form: Top 10 Mistakes You’re Making (and How to Fix Them)

Using Medicare’s ABN form, Advance Beneficiary Notice might be a routine part of your job, but are you sure you’re doing it correctly and compliantly? Providers and staff who treat Medicare patients must know exactly how and when to issue a CMS ABN form to avoid costly write-offs and penalties. If you’re like most providers […]