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Prior Authorization Is Changing

EvidenceCare

Mehmet Oz brought together senior insurance executives for a national roundtable addressing long-known problems with the PA process and will attempt to streamline and improve the prior authorization processes for Medicare Advantage, Medicaid Managed Care, ACA Marketplace, and commercial payers—representing nearly 80% of the insured population.

Insurance 147
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How to Implement Behavioral Health Compliance Best Practices

Relias

To help you better manage your organization’s various compliance needs, let’s delve into what behavioral compliance entails and some best practices to keep in mind. Some of these challenges are common occurrences that can crop up despite staff’s best efforts. Others are less common but are good to be aware of nonetheless.

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Basics of Medical Documentation: What Aspiring Medical Billers and Coders Need to Know

Northwest Career College

Accurate documentation is essential for medical billing and coding, but many beginners struggle to understand the technical terms and guidelines. Without accurate medical documentation, insurance claims can be delayed or denied, frustrating patients and physicians. What is Medical Documentation?

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Navigating Complex Payer Rules in Behavioral Health: A Guide for Providers and Billers

Valant

Understanding Complex Payer Rules in Behavioral Health The rules that payers set dictate how much and what type of information clinicians gather on patients, which billing codes to use, how to document treatment, and which treatments are covered. Heavier documentation. Develop documentation processes. Mental health parity laws.

Billing 94
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Five Reports to Run to Monitor Your Medical Practice

Health Prime

Five essential reports every medical practice should run 1. It categorizes unpaid patient invoices and insurance claims by age, typically in 30-day increments. Compliance and audit reports help you monitor adherence to coding, documentation, and billing standards.

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A Complete Guide to Medical Insurance Credentialing 

CollaborateMD

Whether you’re a physician starting a practice or a healthcare provider working to expand patient access, getting medical insurance credentialing is vital. RELATED ARTICLE: Optimizing Insurance Payer Reimbursement with RCM Services What is Medical Insurance Credentialing? Let’s dive in.

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5 reports that you can run to monitor your medical practice

Health Prime

Five essential reports every medical practice should run 1. It categorizes unpaid patient invoices and insurance claims by age, typically in 30-day increments. Revenue Cycle Management (RCM) Report RCM reports provide a comprehensive view of your practices revenue cycle, from patient scheduling and billing to payment collections.