Can A Person Have Two Health Insurance Plans? Which One Is Primary?

With healthcare costs and insurance premiums constantly on the rise a lot of families are wondering if it might be a good idea to carry two insurance plans. It’s a great way to ensure that specific family members with special needs or unique medical conditions have all the coverage they need. While it might sound like more work having two individual or family health insurance plans, having a second health insurance plan can help you cover some of your [...]

By |April 14th, 2023|Categories: Tips|Tags: |0 Comments

What Is Claim Scrubbing?

On the face of it, claim scrubbing is the detailed process of verifying all the data on a medical claim before it’s submitted to an insurance company or other payer institution. Yet this might sound very simple. It actually required a meticulous process and a professional eye for catching incorrect information as early as possible. Though claim scrubbing is about more than just accuracy and billing amounts. When a claim is processed quickly and efficiently it helps the patient, [...]

By |April 14th, 2023|Categories: Tips|Tags: , |0 Comments

Why It May Be Illegal for a Provider to Waive Patient Responsibility Payments

A lot of insurance companies and public health institutions hold patients responsible for some type of copay for certain medical bills. This is often fine-print language that is built into their policy. Unfortunately, a lot of co-pays can be financially prohibitive for patients. Especially those who require multiple appointments in a week or who are being served by multiple providers. Sympathetic to their patient’s needs, some providers have started to waive co-pays, in order to make it more financially [...]

By |March 13th, 2023|Categories: Tips|Tags: , |0 Comments

Telehealth Updates For 2023 That Affect ABA Therapy Providers

With the Federal State of Emergency set to end in May 2023, lawmakers are scrambling to find extensions or transition options for a wide range of mental health and medical services. Not the least of which is making allowances for telehealth services, which can have a major impact on ABA therapy providers as well as the patients who rely on their care. One of the current proposed bills HB4040 features several telehealth provisions and would extend them all the [...]

By |March 13th, 2023|Categories: Tips|Tags: , , , |0 Comments

ABA Therapy Insurance Coverage by State

Applied behavior analysis (ABA) therapy has grown to be seen by most industry experts as the gold standard for treating autism spectrum disorder (ASD) and addressing other behavioral issues. ABA therapists along with a wide range of advocacy groups have worked tirelessly with state and federal legislators in support of autism insurance reform.  This has helped make ABA services easily accessible to families who have children with autism spectrum disorder. To that point, many state legislators have moved to [...]

By |March 13th, 2023|Categories: Tips|0 Comments

What is a Modifier in Medical Billing?

Efficient medical billing processes rely heavily on accurate coding to generate a claim that insurance companies and public health institutions will rapidly reimburse. This involves several key phases for the clinician providing service, as well as any administrative staff who are facilitating the claims process. If medical coding is incorrect it becomes incredibly difficult, if not impossible for the provider to submit a claim and get paid for the services they provide. This includes diagnostics, therapeutic services, treatments, surgeries, [...]

By |February 8th, 2023|Categories: Tips|Tags: |0 Comments

How to Improve Collections At Your Medical Practice

Collections and securing payment for outstanding debts related to past services rendered can be a very challenging experience for any size practice. Yet it is a necessary component of any healthy revenue cycle that must be completed. A lot of practice managers and revenue cycle specialists will tell you that accounts receivable is one of the crucial priorities for practice survival. Though in the current climate, a lot of practices find themselves struggling with unreliable cash flows due to [...]

By |February 8th, 2023|Categories: Tips|Tags: , , |0 Comments

Differences Between Medical Billing Software & Practice Management Software

Healthcare practices of every scale rely on setting firm financial goals to continue to grow and serve their patients. For some, this involves maximizing efficiency while for others it's about streamlining the claims processing to prevent potential losses. Most thriving practices strive to communicate with their patients. Making sure to notify them well in advance about their bills, schedule appointments, and acquire pre-approval for potentially expensive specialty services. There are even some practices that prefer to outsource administrative functions [...]

By |February 3rd, 2023|Categories: Tips|Tags: , , , |0 Comments

What is Bundling and Unbundling in Medical Coding?

Medical coding is a detailed process of translating critical patient healthcare diagnoses, treatments, therapeutic services, and medical equipment into the standard ICD-10, CPT, and HCPCS codes that are used by the healthcare industry, insurance companies, and public health institutions. These codes serve as a universal language that makes for clear communication while also facilitating coverage and reimbursement for services. Medical practices of every scale and discipline need to use the correct medical codes to accurately describe the services provided. [...]

By |February 2nd, 2023|Categories: Tips|0 Comments

What Does A Revenue Cycle Specialist Do?

A consistent revenue stream is the lifeblood of any medical, dental, or mental health care practice. Incoming revenue is dependent on a properly managed and efficient revenue cycle. When there are delays caused by things like missing information, incorrect information, failure to receive prior authorization, claim rejections, and claim denials it can hamper your practice’s ability to grow. Not to mention taking up needless time sorting out the reasons for the delay. When your skills would be better served [...]

By |February 2nd, 2023|Categories: Tips|0 Comments