The Atlantic published an article recently informing us that 5% of us spend 50% of all health care dollars. A friend commented my sentiments with “this is news?” When I was working exclusively with the older population some 20 years ago, we were talking about similar numbers. In the age of high tech health care,...
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Healthcare billing practices are grossly out of date; ironically just as out of date as our current payment system. Current systems were established post WW2 when employer sponsored plans paid for almost 100% of the price of care. Today, 50% of plans are HDHPs carrying $2000-$4000 annual deductibles with $4000-$10,000 annual out of pocket...
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1. Complete and Accurate Registration Information A successful revenue cycle starts with the registration process. From the spelling of the name to the patient’s date of birth, to the insurance identification number. Assuring that registration data is complete is a must for quick claims turn around and positive cash flow. Depending on your EMR/practice...
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Getting paid by insurance requires a revenue cycle that allows accounts to flow from scheduling to collections with the greatest of ease. Necessary for this are many things, among which are: a up-to-date practice management system, knowledgeable staff, diligent compliance program, and workflows that are automated and void of waste and delays. The revenue cycle consists...
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Common provider contracting network types include, PPOs, HMOs, Tiered networks, and Fee-for-Service. Fee-for-Service or FFS occurs when doctors and other health care providers receive a fee for each service provided, such as an office visit, test, procedure, or other services. An HMO or health maintenance organization is a type of managed care organization. It provides health care coverage through hospitals, doctors, and other...
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Each year duing open enrollment, employees receive a summary plan description that lays out their insurance benefits for that year. A summary plan description lays out the deductible, copays, exclusions, etc. Here is a sample from BCBS of MN. It’s important to understand each patient’s benefits in order to consistent collect as much as...
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Acronyms permeate health care lingo. HSAs/HRAs/FSAs, what are they and how do they differ? An HSA is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a qualfied High Deductible Health Plan (HDHP). The funds contributed to an HSA account are not subject to federal income tax at the time...
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Insurance premiums is the amount paid to the insurance company as a fee for insurance coverage. For those of us employed, the employer typically pays the larger portion of the premium, and the employee pays a lesser amount. In recent years, premiums have increased beyond the rate of inflation and employers requiring employees to...
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