To combat fraud related to the False Claims Act, “the Centers for Medicare” and “Medicaid Services (CMS)” implemented the three-day rule, also known as the “72-hour rule”. This rule requires that all outpatient diagnostic or some other medical services delivered within 72 hours of hospital admission be bundled and billed collectively rather than individually. This … Read more
ERA stands for Electronic Remittance Advice and is used by means of electronic communication where the need for EOB Explanation of Benefits becomes negligible. But what is ERA in medical billing? Medical healthcare providers always wish to have claim acceptance in the first go. And it becomes essential for the providers to reduce/eliminate the recurring … Read more
Hospital stays are expensive. Without medical insurance, it can cost you thousands of dollars. While for some, it may not be the biggest concern, those living hand-to-mouth will be heavily affected by this. For such people, the Federal government offers the Medicare program. It is a health insurance plan designed for people 65 or older … Read more
The Medicare budget Control Act 2011 says that there will be a significant reduction in the reimbursements of the cost of services claimed under Medicare. This federal reduction is specifically called sequestration in medical terms. Medicare claim reduction regulation applies to the claims from April 2013, which is 2% of the total amount claimed, which … Read more
A clearinghouse in medical billing reserves a special place in terms of clearing and forwarding reimbursement claims for practices and hospitals. As the process of reimbursing claims and providing financial security to healthcare providers are essential steps in medical billing, clearinghouses play a key role in the healthcare billing process which is undeniable. What is … Read more
The coordination of benefits is defined by the Centers of Medicare and Medicaid Services as the process by which the patients are allowed to choose who is responsible for their financial medical liability or insurance. This means that through COB, CMS permits patients to have more than one payer or insurance provider. However, through COB, … Read more
Like any other practice, chiropractors also need to adhere to the important set of codes called CPT codes. AMA maintains chiropractic CPT codes – American Medical Association and is regularized by the CMS across the chiropractic providers. CPT codes are comprised of five alphanumeric typo scripts, that are used to evaluate, describe, and diagnose all … Read more
Whether you’re an OSHA-approved trainer or a front-line supervisor, creating an effective bloodborne pathogens training program can feel like a Herculean task. You must also do it quickly — and with little to no budget. But don’t panic; you can create an effective training program with the right approach. Even if your company is small … Read more
The medical industry has been affected by scams and fake medical bills for ages and till now there have been no easy solutions for the prevention of manipulation and tempering of such issues at the receiver’s end (i.e. hospitals and providers) or the processors’ end (i.e. insurance companies). The Healthcare industry needs a quick solution … Read more
With the changes in almost everything in the healthcare industry, including regulations, credentialing process, treatments, and procedure claims, the healthcare reimbursement models ought to have a shift as well. It has become an obligation to meet America’s ever-increasing medical needs. For building secure and quick reimbursements, changes in models for providers’ reimbursements will bring much … Read more