Friday, December 19, 2014

The Hardships of Raising a Child with ADHD

Although at first it might seem like a natural impulse of curiosity for your kid to roam around in his classroom and fidget, never staying put, medical experts might see it in another way. It is possible that your child might be suffering from attention deficit hyperactivity disorder, or ADHD (sometimes ADD), which could be a really hard pill to swallow for parents.

A child suffering from ADHD might demonstrate more than one of these indicators: difficulty in paying attention to details and tendency to make careless mistakes at school, inability to focus on one task, procrastination, disorganized work habits, and forgetfulness in daily activities (for instance, forgetting to bring lunch to school).

Sunday, December 14, 2014

The Medical Aspect of Disability Insurance

One of the key things you should be aware of when you’re applying for Social Security Disability Insurance is that the folks at the Social Security office will scrutinize whether or not you are, indeed, showing signs that render you unable to function well and earn a living. That said, Social Security will check your medical records to see if the conditions you’re exhibiting are legitimate.

Sunday, December 7, 2014

Debunking Common Medicaid Myths

Medicaid is an extremely helpful benefit in itself, but like any other aid of its structure, it’s still subject to numerous myths that hinder people from making full use of its benefits. Here are some of the most common:
Only poor people are eligible – Medicaid was enacted in 1965 as a means of providing medical assistance to all qualifiers, and the rules simply don’t state that only less fortunate people are eligible for assistance. Sure, poor people are more likely to qualify, but virtually anyone can—provided that they adequately meet the set standards or criteria.

Tuesday, December 2, 2014

Tips for Navigating the Affordable Care Act Marketplace like a Pro

In some cases, the plan that your employer offers you may already be exactly what you need. Take the time to go over this option first as it should save you a lot of time in the long run. If what your employer offers isn’t enough, it’s time to search the marketplace. Your Medical History Be sure to check if your doctor is included in the plan’s list of accredited doctors. Otherwise, you will have to start seeing a different physician. If this happens, get the list of accredited doctors and run a quick background check to see if they meet your needs. Similarly, you should also see if any current prescription drugs are covered by your new plan.

Monday, December 1, 2014

The Most Important RCM Metrics You Must Measure

Revenue cycle management (RCM) is tough enough work as it is. Still, most of the burden can be eased by keeping close watch of five major metrics, namely:
FPRR – AKA the first-pass resolution rate, the FPRR points to the share of a practice’s claims which get paid upon only the first submission. Keeping track of this metric ensures a bird’s-eye-view of a practice’s RCM processes, from verifying insurance eligibility to coding and billing.

Sunday, November 30, 2014

Determining Your Eligibility for Social Security Disability Benefits

The SSA has a very strict definition for the term “disability”. As a result, not all medical conditions and injuries fall under the definition they have set. Specific conditions and injuries covered by the SSA can be found in their “Blue Book”, which can be found on their website. Despite the strict nature of the SSA, they are open to allowing several exemptions and approving a disability Social Security application. For example, migraines aren’t a condition listed in the “Blue Book”, but if they are severe enough that it prevents a person from working a normal job, the SSA may decide to cover the condition anyway.

Friday, November 28, 2014

How to Work with Patient Eligibility for Medicaid in Revenue Models

Determining patient eligibility for Medicaid is the first important step every healthcare provider should do when receiving uninsured patients. Failure to do so can lead to negative consequences for both the patient and the receiving practice. A patient advocacy system, such as one offered by DECO Recovery Management, can be useful in educating uninsured patients about their benefits under the ACA, and helping healthcare providers properly secure their revenues. Healthcare claims can be denied if the patient cited inaccurate coverage information or simply lacks the authorization to enjoy medical services or treatments. These denials can hold up the revenue flow, stifling the payment due to the healthcare provider. Denied claims from uninsured patients can quickly add up over time, and can eventually lead to large losses for the practice involved.

Wednesday, November 26, 2014

What is Revenue Cycle Management’s Role in Improving Medical Practices

As with any business, healthcare practices need to get creative with how they can manage their revenue or risk losing their earnings. Practices, however, are not always paid in the same way other retailers are, since their patients collaborate with insurers to halve the bills. This makes understanding a practice’s revenue a complex affair. What is a revenue cycle management system suitable enough for practices to use in order to streamline their operations and better themselves? Revenue cycle management is meant to help healthcare providers with keeping track of their patients’ claims and payments. Without the proper tools and skills to conduct revenue cycle management, practices will be hard-pressed to ensure proper workflow, and they might even lose money for their disorganization. Practices that have management systems in place will not only improve their revenue flow, they will also boost their patients’ satisfaction.

Monday, November 24, 2014

Social Security: Disability Benefits for Children

Most people are aware of the importance of social security. Some are not mindful, however, that certain benefits can extend to their family members, particularly their children. According to Daily Finance, of the approximately 58 million Americans who apply for and have Social Security, around 6% (or around 3.4 million) beneficiaries are disabled children.

Wednesday, November 19, 2014

Patients Dealing with Hearing Loss

Sound helps enhance understanding of an object or surroundings – in the case of a forest, a casual chat or a snapped twig may carry dozens of feet. However, hearing can degrade with the passage of time due to age or other circumstances. If this has affected your patients’ regular activities to a major degree, they can file a claim for disability social security benefits. Here are some things you need to understand about this:

New Health Insurance Marketplace Coverage Options may be a Maze for SC

Picking the most suitable and affordable plan will definitely be the biggest concern for patients, and they shouldn’t rely on their old methods if they want to achieve that. A survey from the state’s Insurance Department revealed that previously, patients took only an average of 15 minutes shopping for a plan. Their decisions were largely based on the premium payments. In reviewing new health insurance marketplace coverage options, patients need to consider the out-of-pocket expenses linked to their coverage, aside from premium rates. They must check the plan’s affordability by factoring in the copays, deductibles, and other expenses that they need to satisfy if they use the health insurance, which could easily amount to thousands of dollars per individual.

Monday, November 17, 2014

Applicants for Support for Disability from Social Security Get Help

Both attorneys and advocates are paid the same rate, which is regulated by Social Security – roughly 25% of the retroactive payment received by the applicant, up to a maximum of $5,300. Social Security usually withholds the payment to lawyers while applicants pay non-legal attorneys directly. Timing is everything Lawyers and advocates, such as Deco: The Eligibility Experts, recommend patience to applicants when applying for SSDI. Ideally for social security disability eligibility, employees need to have been unable to work for at least five months. Applying soon after becoming disabled and getting approved means receiving little or no retroactive benefits paid (and a smaller fee for the advocate).

Saturday, November 15, 2014

Screening Eligibility for Medicaid Assistance even while Behind Bars

Some proponents of the expansion claim that the state and local governments may save more when people, especially newly-released prisoners, are insured for health practice visits instead of going to the ER, as had been the norm for years. A few studies noted, for example, that former inmates who visited the clinic periodically stood a 50% less chance of being sent to the ER than people who did not. As such, determining eligibility for Medicaid through companies like DECO will be essential to aid people in dire need of medical assistance.

Thursday, November 13, 2014

Sticking to Integrity to Understand What is revenue cycle management

A healthcare company using strategies crafted by supporting revenue cycle management companies often deals with hard numbers when it comes to assessing earnings as much as the numbers of patients treated. A senior vice-president of an RCM services provider said the process requires full accounting of how much money the practice may be losing because of some discrepancies like inadequate documentation. Keeping things in order and communicated around the organization may enhance service efficiency.

Wednesday, November 12, 2014

Update Your Medicaid for More Serious Diseases

Recent health scares such as Ebola have been a great cause of concern around the world. State health officials in South Carolina, in particular, have been conducting the necessary steps to address potential cases of Ebola and other serious viral diseases by means of a statewide referral system that allows patients to get immediate medical attention.

Wednesday, November 5, 2014

Quarantine Costs Strain Revenue Cycles

Now that the Ebola outbreak has reached U.S. soil, it's up to hospitals and medical facilities around the country to keep it in check. The cost: $1,000 an hour.

At least, that's the figure experts came up with after computing the cost of Thomas Duncan's treatment at Texas Health Presbyterian in Dallas. During his nine-day confinement, Duncan racked up between $18,000 and $24,000 per day, according to a Bloomberg report. Including indirect costs, his total bill may reach half a million dollars.

Monday, October 20, 2014

New Health Insurance Marketplace Coverage Options—The Benefits of ACA

Essential Health Benefits include ambulatory patient services, emergency services, and hospitalization. Although this particular modification in the health care insurance system only applies to non-grandfathered insurance or those insurance plans that have been in effect since March 23, 2013, all other insurance plans that took effect prior to the implementation of the ACA though renewed after its inauguration shall provide coverage for Essential Health Benefits. On the other hand, the new Affordable Care Act Marketplace or Health Insurance Marketplace provides an avenue for those who are having difficulty looking for health insurance that suits their needs. At any rate, one needs to weigh the available options carefully. Forlger further adds.

Get Immediate Payment for These Child Disabilities

Social Security Income (SSI) payments for children with disabilities are made on a monthly basis to children with low income and limited resources who are younger than 18 years of age. Payments for child disabilities vary per state as certain jurisdictions offer additional payments to the standard SSI benefits. However, parents and relatives of children with disabilities have to remember that disabled minors must meet the requirements for benefits and that the parents or legal guardians must have a good Social Security earnings record.

Normally, it would take about three to five months for the relevant authorities to determine the eligibility or non-eligibility of a child for disability payments. However, certain medical conditions may result in the immediate awarding of benefits payments even before the Social Security Administration (SSA) or the local Social Security office decides on the application.

These medical conditions are as follows:

Sunday, October 19, 2014

Social Security Disability Benefits: A Closer Look at SSI and SSDI

You also need to factor in cost-of-living adjustments COLA. This is an addition to the current regular benefits based on how much the cost of living has increased in your area. The current adjustment is at 1.5 percent. When applying for Social Security Disability benefits, you have to expect this adjustment to appear should you get approved. SSDI and SSI have helped many Americans cope with illness and disability. Yet due to the sheer volume of claims the SSA receives annually and the strict requirements involved, the eligibility process may be long and tedious. When applying for Social Security Disability for children, therefore, you might want to hire an eligibility expert like DECO Recovery Management that can help you complete all requirements and forms, as well as file an appeal in the event of denial.

Saturday, October 18, 2014

Changes in Eligbility for Medicaid Coverage Have Hospitals Gearing Up

Hospital revenue cycle management services help untangle these complications and streamline a hospital’s existing revenue strategy. A company like DECO Recovery Management, for instance, can create plans on how to get rid of bad debts and improve cash flow. This process involves several aspects. Among other things, a company like DECO Recovery management can assist Medicaid-eligible patients as well as those who wish to claim Social Security disability benefits with their applications for successful claims processing. Each of these benefits have their respective eligibility requirements, and applicants must go through a step-by-step process involving five questions before they can be considered “disabled”. In case of denial, an eligibility expert can help the applicant file an appeal with the Social Security Administration.

Friday, October 17, 2014

Revenue Cycle Management Services Maximize Your Income Post-Obamacare

Cutting costs may be a good way to enhance revenue, but there are other aspects you need to consider. For example, you may still have some bad debts as well as accounts that have yet to meet your revenue targets. You need to do something about these things—fast. Consider revenue cycle management services that allow you to focus on actually managing your facility and providing quality care to patients. A company like DECO Recovery Management can conduct a review to locate where problems often arise to address issues such as underpayment . So-called eligibility experts also assist patients with financing options and help ensure that your facility gets reimbursed for services rendered. Ever wondered what revenue cycle management is all about and what improvements need to be made to reduce bad debts or uncompensated care? Then you might want to turn to an expert you can trust.

Tuesday, October 14, 2014

Figuring Gulf War Service Ailments

A considerable bulk of today’s active-duty and retired veterans will have seen action during the Persian Gulf War back in the early 1990s and continued service as part of the War on Terror. However, medical disorders that came about as a result of the Gulf conflict – the so-called Gulf War Syndrome (GWS) – have complicated matters for veterans who’ve sought disability insurance benefits. This requires a clearer understanding of how GWS factors in when applying for Social Security Disability insurance.

Tuesday, October 7, 2014

Tips for Efficient Medical Billing

Thanks to today’s economy, medical practitioners often have the misfortune of having to choose between doing their healthcare duty efficiently and doing the business of their practice effectively. When billing comes, factors like identifying eligibility for Medicaid could potentially delay the process and keep revenue from flowing smoothly.

Wednesday, October 1, 2014

Ethics of Maximizing Reimbursement

Behind every instance of your patients flashing their Medicare or Medicaid card is a three-step process for filing your reimbursement. Proper coding comprises two-thirds of the task, which is why it's important to get the codes right. Aside from the ICD-9 (soon to be phased out in favor of the ICD-10), practitioners have their own local codes.

Physicians use the current procedural terminology (CPT®), a coding system maintained by the American Medical Association developed in 1966. The CPT® is updated yearly to include as many treatments and diagnoses as possible. The codes evolve along with the evolution of medical technology and recent discoveries in the field.

Wednesday, September 24, 2014

How Social Security Can Help Disabled Children

Medical bills can be a huge and expensive problem for anyone. This even complicates things when the bills are for treatment of your young disabled child. The government has instituted some safety nets for such families with low incomes to enable them to seek the treatment their disabled child needs.  This main safety net is Social Security.

Monday, September 22, 2014

Reasons why your Social Security Claim is Denied

Applicants for Social Security benefits tend to think of the reasons why their claims for benefits should be granted, and seldom dwell on the reasons why they may be denied. Here are some of the more common reasons why SS claims get rejected.

Wednesday, September 17, 2014

Facts about Common SSI and SSD Programs

When a person becomes injured and unable to continue working in his chosen field, the government grants him special compensation benefits depending on the nature and gravity of his condition. Here are some of the government programs that you can check out, should you or one of your loved ones be incapacitated for work:

Monday, September 15, 2014

Coding Errors and Denials: How to Avoid Them

You may not be aware of it, but your hospital may already be losing money because their revenue cycle is not optimized. How you may ask, when you’ve made sure that everything about billing has been accurate so far? Have you thought about denial management? If your hospital has not fully evaluated its coding processes and optimized them, then you may not be getting the proper amount of reimbursement for the amount and level of care you are providing.

Monday, September 8, 2014

What is Good Revenue Cycle Management and its Impact on NC Hospitals?

Good revenue cycle management can be achieved in a lot of ways, but they all begin with hospitals properly reviewing their healthcare data. It’s important for them to identify denied claims from their database early on because these can significantly affect their revenue cycle. In fact, denials can cause a hospital to miss about 90 percent of its revenue opportunities because they lead to plenty of missed collections and a long time for accounts receivables to just sit there, waiting to be paid. Working with healthcare eligibility specialists like those from DECO Recovery Management can help NC hospitals optimize revenue by making absolutely sure that their patients are eligible for benefits in the first place, and in cases that they’re not, find the workaround for patients’ eligibility. Eligibility experts add value to what revenue cycle management companies do by mainly ensuring the recovery of revenue from accounts receivables.

Tuesday, August 26, 2014

On the ACA: Towards New Health Insurance Marketplace Coverage Options

For those interested in finding a suitable health plan, the online Affordable Care Act marketplace has made it possible for people and small businesses to find and buy a subsidized plan for themselves. This marketplace will provide many government-owned private health care providers to choose from and will not be able to deny health insurance to anyone based on health status or gender. Obama’s health care plan foregoes the annual and lifetime limits on coverage and gives access to Americans making less than 400% of the Federal Poverty Level. Despite the criticism given by many lawmakers and select citizens alike, the Affordable Care Act has given health care coverage to more Americans. If you are still uninsured and wish to apply, finding out if you’re eligible for the ACA with the help of consultants like those from DECO Recovery Management is a good way to start.

Monday, August 25, 2014

SSD Insurance Eligibility for Disabled Children

Aside from social security disability (SSD) services, the proper agencies themselves have also taken measures to clarify who qualifies for SSD benefits. Although the common perception is that senior citizens are the primary benefactors, disabled minors can also enjoy SSD benefits.

The SSA's factsheet on SSD insurance highlights three simple rules that identify an eligible disabled child. Here are the rules in detail.

Sunday, August 24, 2014

Social Security Disability Benefits: For People with Disabilities

The SSA has set guidelines for eligibility for their social security disability insurance programs. This is for people who are not born disabled as there are other programs that cater to them. For these tests, if one incurs a disability from an accident (for example), one would qualify for benefits if one had worked for a total of 7 years in the past. One could also qualify if one had worked at least 5 years out of 10 leading up to the period the disability began. The test is based and depends on the age such disability was incurred or began. This “duration of work” does not have to fall within a particular period of time.

Friday, August 22, 2014

A Look into Eligibility for Medicaid and Benefits of Being Qualified

Applicants denied for Medicaid will be notified accordingly. In the meantime, if they would need medical care, they can seek hospitals and clinics who open their doors to the uninsured. In turn, hospitals can refer these uninsured patients to eligibility specialists, like the ones from DECO Recovery Management, to learn more about their eligibility and appeal the denial. Patients who are approved for SC’s Medicaid program play a vital role in healthcare revenue cycle management systems. However, SC has eligibility requirements that patients must comply with first. Once they are deemed eligible, they can enjoy the benefits of Medicaid including a comprehensive medical coverage.

Sunday, August 17, 2014

Get SSA to Approve that Disability Claim

With 12% of the American population having some form of disability, it is not surprising that the Social Security Administration (SSA) gets over two million Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) applications every year. However, not more than six hundred thousand of these applications are approved and awarded benefits during initial determination.

The SSA denies many SSI and SSDI benefits applications over technicalities that could have been avoided with preparation or guidance from eligibility specialists. Some of the common reasons for application denials are:

Sunday, August 10, 2014

Revisiting New Provisions for Medicaid

You may have failed to qualify for Medicaid last year, but with this year's expansion, you might just be one of 100,000 newly eligible Marylanders. Thanks to the Affordable Care Act, coverage is now expanded for the poorest Americans by allowing the states to provide Medicaid eligibility, starting Jan. 1, 2014. To qualify, an applicant must be within ages 19-64, a U.S. citizen or qualified alien with 5 years stay in the country, and a legal resident of MD.

Tuesday, August 5, 2014

The Affordable Care Act Marketplace is Open to Those Who Lost Coverage

When this happens, you’ll need to find a way to replace the coverage you’ve recently lost. One way to do so would be to check new health insurance marketplace coverage options. The Patient Protection and Affordable Care Act, a.k.a. Obamacare, has made health insurance much more affordable to people, and you would be wise to see what options are available to you. You may recall that Obamacare had an open enrollment schedule earlier this year, and that open enrollment window is now closed. This doesn’t mean you can no longer apply for health insurance. The main point of Obamacare was to provide every American with affordable healthcare, and that those who truly need insurance cannot be denied coverage.

Sunday, August 3, 2014

Why is Revenue Cycle Management Necessary?

Running a health practice is simultaneously a rewarding and challenging endeavor. On the one hand, you get to heal people of what ails them; on the other, there’s a mound of paperwork you need to accomplish. Then there’s also the issue of collecting payments from the patients you’ve treated.

To make daily operations smoother, many hospitals and clinics utilize what’s called a revenue cycle management (RCM) system. This tool, which is a type of software, offers two key benefits:

Knowing Social Security Disability Eligibility: Qualifying Conditions

To determine just how severe your disability is, you will have to undergo extensive medical examination. This can either be required by the SSA (in which the federal agency may shoulder the financial aspects), or requested by your legal representative for appeal purposes in case your claim is denied. If you’re not sure and need to confirm your social security disability eligibility, you can always depend on private firms like DECO Recovery Management to advise you on eligibility matters. Make sure that you confirm the chances of your eligibility before attempting to file your claim to avoid wasting time and money that you could have used to remedy your financial condition instead.

Friday, August 1, 2014

Optimizing Healthcare Revenue Cycle Management for Medical Businesses

How well you begin the revenue management process is crucial to how fast you can get paid. This means that you should hire competent receptionists and registration personnel to get the patient’s contact details. Whoever is at the desk to answer calls or take patient data should already know the questions to ask and the kind of information to collect. Creating patient records should be fast and efficient. Verify Eligibility Immediately As part of the data gathering process, you should have your receptionist confirm the patients’ eligibility for Medicaid, even before he goes to your office for the appointment. Pre-visit verification will make things easier for your office, so that information is clear and laid out, and whatever data needed to be added have been recorded or corrected. Sometimes, appointments have to be rescheduled until coverage for the patient has been determined.

Wednesday, July 30, 2014

Revenue Cycle Management Companies: TCPA and its Potential Impact

To comply with TCPA requirements regarding patient contact, your practice needs to verify three things: First, the identity of the patient receiving the call; second, that you have permission to contact the patient at that specific number with the technology used to generate the call, and; third, if you’re calling a mobile or residential phone. Not sure if you’re complying? Knowledgeable revenue cycle management companies like DECO Recovery Management can provide you with a proven revenue cycle solution for these and other related needs. Get in touch with these companies to learn how they are helping healthcare providers like you to address these all too common revenue cycle challenges.

Thursday, July 24, 2014

Facts to Remember Before Applying for SSI Benefits

Families who are struggling to financially support a child suffering from disability can submit an application for Supplemental Security Income (SSI) to the Social Security Administration to ease the monetary burden. Before applying for these benefits, however, parents are encouraged to review these facts.

The Administration employs strict standards in determining who falls into the definition of “disabled”. Aside from a debilitating physical or mental condition, the condition must be projected to last at least a year or result in eventual death. Other examinations may be requested as necessary, which will be paid for by Social Security.

Children aged up to 18 years old can qualify for SSI disability benefits if they meet the aforementioned conditions for disability and little to no income or resources. The family’s household income, resources, and other particulars are also taken into account.

Parents should take note that it can take up to 5 months for Social Security to decide on an application. An official letter will be sent once approval has been granted.

Applicants should keep in mind that while benefits are available, SSI is not meant to be a medical assistance program that supersedes state Medicaid agencies, local health departments, or hospitals. Families are encouraged to approach these organizations or the nearest health agencies first before considering undergoing the lengthy and rigorous process of security SSI disability benefits.

Thursday, July 17, 2014

Disability Social Security: An Introduction

The Social Security Administration (SSA) manages a program called disability insurance or disability social security which insures a worker in case of a mishap. Enforced using the Federal Insurance Contributions Act (FICA), the SSA collects regular contributions from employees, with these collections forming part of their Social Security fund. This federal legislation makes it possible for employees to receive income insurance for at least one year when they become disabled.

The process of applying for disability social security involves passing stringent tests that the SSA sets to ensure that only those who really qualify and need it can benefit from this form of assistance. First, applicants must meet the government agency’s definition of being “disabled”. Then, they must prove that their current medical condition impairs them from continuing to do their work or from taking other types of occupation.

After careful review of applications for disability social security and other supporting documents, SSA can decide to grant or reject a worker’s application for the said income insurance. If approved, beneficiaries need to wait for their first payment six months after the decision has been made. If the application has been rejected, applicants can file an appeal with the SSA to overturn the decision. Employees have to prove that they are qualified for the benefit and meet the specific requirements of the compensation program.

Wednesday, July 16, 2014

New Health Insurance Marketplace Coverage Options for Small Businesses

"Eligibility for coverage in the SHOP marketplace is achieved either individually or as a company. For a business to be considered eligible, the owner must prove that the enterprise indeed falls under the “small business” category and that all employees agreed to enroll in a health plan. Depending on the jurisdiction, you may be able to get health coverage from the Affordable Care Act marketplace even if only 70 percent of your employees are enrolled. Whatever the arrangement may be, you will need the help of a reputable Health Insurance Marketplace Navigator like DECO Recovery Management to ensure that the application process goes as smoothly as possible. This way, you can weigh your options more intelligently and provide optimum coverage for your employees."

Monday, July 14, 2014

Social Security Disability Benefits: Factors the SSA Has to Consider

"The application process is straightforward. To qualify for the benefits, you must first prove that you were at the right age when you became disabled; that you worked long enough in a job covered by SSA; and that your disability is sufficient for entitlement. In the case of non-employee applicants—disabled children, for instance—SSI provides Social Security disability benefits for children in the form of supplemental security income. Documents proving that the family taking care of the child belongs to a lower-income bracket are required. While the process sounds simple enough, some issues surrounding your application may complicate it. In such cases, you will need the help of eligibility experts from companies like DECO Recovery Management to increase your chances of getting approved. These experts can prepare and file your documents as well as help you obtain fair financial support."

Saturday, July 12, 2014

Expanded Eligibility for Medicaid: How Healthcare Providers Can Adapt

"Medicaid’s recent expansion will no doubt require health care providers to improve their existing healthcare revenue cycle management systems. Any such improvement should help monitor a practice’s income by improving the efficiency with which it determines patient insurance eligibility, collects co-pays, and codes claims under the new healthcare system. Eligibility experts from companies like DECO Recovery Management can facilitate this transition and ensure that healthcare providers as well as their patients are properly covered under the new system. Whatever changes Obamacare and subsequent healthcare reforms may bring about, it is clear that hospitals need to better manage the non-clinic aspects of their operations so they can focus on providing quality care. Custom-fit solutions from a revenue cycle expert like DECO Recovery Management make it possible for the uninsured and underserved members of society to get the healthcare they need and at the same time allow hospital operat

Thursday, July 10, 2014

Common Questions about Medicaid Eligibility

Many Maryland residents have lauded the passing of the Affordable Care Act (or “Obamacare” as it is commonly called). Of course, many of your patients are probably unaware that there are already laws that seek to make medical care affordable for people, especially those in dire financial straits. Case in point: the Medical Assistance program or Medicaid.

This provision was created in 1965 to assist low-income individuals who are either under 21 or over 65 years old, pregnant, disabled (or caring for a child who is), or responsible for children under 21 years old.

As with any law, though, expect your patients to have plenty of questions about Medicaid eligibility. Below are some that you might encounter:

Where Can I Get Application Forms?
To make things easier, the state has made application forms available online. Your patients may download them from:

What Services are covered by Medicaid?
Medicaid covers a variety of medical services such as ambulatory surgical center services, laboratory and x-ray services, and even mental health management, among many others.

What if I Make Too Much Money?
If a person makes too much money to qualify for Medicaid, they may still take advantage of this program via the “step down” procedure. This requires the applicant to show that his or her medical expenses exceed their income.

If you need help explaining the full benefits of Medicaid and assisting patients to enroll, you can tap third-party specialists like DECO Recovery Management.

What is Revenue Cycle Management and How Can it Benefit Hospitals?

"Since a majority of patients may be enrolled in an insurance policy, gathering accurate data and verifying information becomes top priorities. After patients provide insurance information, it is advisable to confirm eligibility for coverage prior to hospital admission. Through this practice, the hospital can avoid expensive liabilities and minimize the likelihood of claims being denied, which can cause undue inconvenience to patients. As the EHR Intelligence excerpt suggests, using a certified EHR technology makes the process more efficient. The automated system can record insurance information aside from other health data, so the hospital can send batches of data to a clearinghouse for eligibility confirmation. Through proper guidance on these innovative programs, leading revenue cycle management companies like DECO Recovery Management enable hospitals to improve their collection strategies and focus on providing better care to patients."

Thursday, July 3, 2014

Streamlining the Revenue Cycle

A revenue cycle refers to the activities involved in the sale and delivery of goods and services to the customer. From the endorsement of goods and services to managing transactions, revenue cycles are basically the core of doing business. Every industry, including healthcare, has its own revenue cycle.

The cyclical process ensures continuous revenue for the medical facility over the course of the patient's life. However, the risk of a domino effect affecting the entire process is higher, which is why medical facilities must take extra care when processing transactions. A minor error at any point in the process can cause a chain reaction, affecting revenue and customer satisfaction.

Technology opens a new world of possibilities in improving the revenue cycle, although it's still important to keep in mind that technology is only as good as the human input. By using state-of-the-art software and revenue cycle solutions, medical facilities can streamline the revenue cycle with a lower risk of creating issues and concerns for the customer.

These systems will become essential as medical billing makes the shift to the newer ICD-10 standard. It will implement more billing codes than its predecessor the ICD-9, and this change will surely create more confusion for a medical facility without a revenue cycle management system.

Monday, June 23, 2014

How Do Children Qualify For Disability Benefits

The Social Security Administration (SSA) normally grants monthly payments to disable people and low-income individuals. But children can also qualify for supplemental security income payments if they are under 18 years of age and have conditions that fall within the government definition of disability. Here are the requirements underage applicants must meet for SSA to consider them disabled:

Must Not Be Working
The child applicant must not be working or not earning more than $1,070 per month (in 2014) to be called disabled.

Monday, June 16, 2014

Qualifying for a Social Security Disability Benefits

The Social Security Act defines disability as a chronic condition that prevents a person from engaging in any significant activity because of physical or mental impairment. The condition may last or is expected to last for a long time, or is expected to result in death. Because of these inopportune situations, the US government is stepping up to help those people in need.

Those who have worked previously before impairment can qualify for Social Security Disability Insurance (SSDI). Monthly benefits, such as cash compensation and Medicare, depend on the person’s earnings. Some family members of qualifying beneficiaries can also receive benefits from the insurance.

Monday, June 9, 2014

The Ins and Outs of Medicaid Eligibility

In a country with the world’s best healthcare system, being strapped for cash should be no excuse to seek assistance with one’s health issues. For those who find the cost of healthcare too much to bear, Medicaid, which guarantees free or low-cost care, may be one viable solution to the problem.
In order to qualify for Medicaid, however, applicants must meet certain income and family size restrictions. Medicaid programs in different states all follow a set of federal guidelines when implementing these restrictions; however, these can vary somewhat from state to state. Additionally, recent expansions to Medicaid have changed the eligibility guidelines, though some of these developments have yet to be applied in certain states.
Due to these variations in implementation, interested applicants should check the

Monday, June 2, 2014

Understanding Revenue Cycle Management

Hospitals and different health care institutions rely on a steady influx of revenue to ensure that they stay in business and function more effectively to serve the public. To make sure that they are able to meet the daily requirements of expenses to stay in operation, medical institutions and offices establish proper revenue cycle management into their business approach. You may ask, “What is revenue cycle management?”
Revenue cycle management is the process of taking the appropriate steps to guarantee timely payment for medical assistance. The revenue cycle begins when a patient first calls into a doctor’s office for an appointment, or visits a hospital and provides the staff with his name, phone number, and the name of his insurance company. The cycle ends when the balance on that patient’s account is completely cleared.
To properly keep track of the entire process, technology is employed to automate the process, which largely involves cataloging patients’ data and managing their file throughout, so that healthcare providers can follow through the progress of each patient and address any issues that may arise.
Revenue cycle management facilitates other patient-related financial activities, as well. Using the automated process, healthcare providers can quickly check a patient’s insurance eligibility before admission. With quick and easy access to a patient’s file, medical institutions also gain the ability to counsel patients on the spot about high-cost procedures and how some of the treatment approaches may impact their finances.

Friday, May 23, 2014

Knowing the Disability Benefits for Children

Having a disabled child can be a heartbreaking experience for any parent. The emotional toll that this exacts on any caregiver is staggering and the attendant financial cost can be steep. The difficulties can seem insurmountable, but there are ways to get help; one of these is to apply for social security benefits for your child.

The benefits available for your disabled child come in two types: Social Security Disability Insurance and Supplemental Security Income. The two are often confused, each is distinct from the other. First, SSDI is dependent on whether the parent has paid for social security benefits in the past, while the SSI looks at the limited resources of the family and the disability of the child. The child’s disability should be severely limiting, and that he or she must have had it for more than a year.

SSI is also more limiting since it has no dependent benefits. This means that families under SSI receive only what the plan offers. SSDI is more flexible—for the disabled sole wage-earner, for instance. SSDI allows to provide fifty percent each (of the main claimant’s benefits) to the disabled’s spouse and dependents for as long as the awarded disability payments fall within the 150%-180% total maximum range, and not more.

To claim benefits from SSDI or SSI, the parent of a disabled child must apply for them. Though it can be relatively uncomplicated to accomplish this, most people need help from federal benefits eligibility services like DECO Recovery Management to ensure that they stand a higher chance for approval.

Tuesday, May 20, 2014

Tips on Filing a Social Security Disability Claim

Filing a social security disability claim can be an inconvenient affair. It can be confusing and taxing; unless you have enough resources to follow through, the assistance of other people in the know, and tons of patience, you might probably give up and wait another year. Here are some pointers to help you through the rougher spots with your application. 

Unless you know a lot about law, better hire an attorney! Most people might forego this option, mainly because they think it costs a lot of money. Yes, you’ll need to pay for professional help, but you don’t need to pay everything upfront. Social security disability lawyers are mandated by the law to work on a contingency basis; that is, they cannot charge for attorney’s fees until they have won your case.

Always remember to keep in touch with your attorney, and update him whenever needed. However, keep in mind that hounding your lawyer will do nothing. No matter how eager you are to know the progress of your application, your lawyer can’t do anything much while he’s waiting. What he can do is to make sure that you have provided all the information required for your claim to stand a chance for approval.

Do not be discouraged if you’re denied the first time. Don’t lose hope if you get blocked on your initial application! Remember that every denial gets you closer to a court hearing, which may be an advantage to you.

Continue visiting your doctor. Your claim will need updated evidence of your disability every now and then. Doing so regularly (at least every 3 months) will keep your information about your disability current, a crucial factor in the approval of your claim once you get into a court hearing.

Thursday, May 15, 2014

Facts about Medicaid Patient Eligibility

Basically, in all states, Medicaid caters to low-income families or parents and their children, pregnant women, seniors, and persons with disabilities. Varying types of coverage are available for people with different needs, and each also have their own income brackets and resource limits. Hence it is important for anyFor health care providers, it is imperative to first determine whether a particular patient is eligible for Medicaid, and by how much is he covered.

Basic Requirements
To be eligible for thisMedicaid, the a patient should: be a U.S. citizen or, if an immigrant, must show proof of eligible immigration status. ; supply proof of residency, and; The patient should also have a social security number or have applied for one.

Aged, Blind or DisabledAutomatic eligibility
These three qualifications belong to one bracket, and it’s main requirement is of course being able to prove that you are either of the three. ‘Aged’ refers to people over 65 years of age. Blind and disabled people will have to undergo medical examination before being deemed eligible.A patient is automatically eligible if he is already receiving any of the following benefits:

  • Work First Family Assistance
  • Special Assistance to the Blind
  • Supplemental Security Income (SSI)
  • Adult Care Home Assistance

Infants and Children
Medicaid for Infants and Children, or MIC, provides coverage for those under 19 years of age. In this case, there is no limit for resources, but the income limits are to be determined by the size of the family and the age of the child seeking coverage.

Long-Term Care
Another great thing about Medicaid is that it could also pay for long-term care such as the cost of nursing homes, and intermediate care facilities. In both these cases, the income should not exceed the cost of the long-term care being given.

Monday, May 12, 2014

Revenue Cycle Management Explained

Revenue Cycle Management (RCM) is a process that allows a healthcare provider to manage payment, claims processing, and revenue generation. In simplified terms, RCM helps a healthcare provider ensure that he or the facility gets paid timely for services rendered. It entails using technology to manage claims processes at every phase so that the provider doing the billing can monitor the process and address any issues, allowing for the continuous generation of revenue.

The term revenue cycle is highly associated with healthcare. Although many non-health companies follow the same processes of a revenue cycle, they usually call this process by some other names, such as sales or production cycle. In healthcare, the revenue cycle encompasses the entire patient engagement and payment process—from the time a patient calls your office for appointment to the time the balance on his or her account becomes zero.

Effective RCM requires solid data gathering, storage, and dissemination. This means patient data needs to be collected accurately, the bill sent to the insurance company ASAP, and everything else in between is accomplished. Efficiency and time management play huge roles in RCM, and a healthcare provider’s choice of hospital assistance provider will be the main factor that would help him (or the facility) reach targeted revenue goals.