Friday, August 28, 2015

Huge Life Changes and New Health Insurance Marketplace Coverage Options

Making the right choices with regard to your health should be a top priority. If you’ve already selected one of the new health insurance marketplace coverage options available this year, yet wish to change it as a result of a significant life change, you’re not alone. You might not have to cancel your current plan altogether but just tweak it. Your health insurance, after all, should adapt to your needs.

How Claim Conflicts Affect RCM

A vital part of a hospital’s revenue cycle management (RCM) is managing claims. In many cases, patients simply can’t, or at least not fully, pay hospitals out-of-pocket. Instead, their payment will come in the form of an insurance or government benefits program. The insurance provider or the government will hand the payments to the hospital but not before a claim is made and approved.

Thursday, August 27, 2015

Reasons for Denial of Claims for Mental Disability Social Security

Winning benefits for a mental disorder is a particularly troublesome. The process of approval is already difficult enough as is, but claiming benefits for mental illnesses is harder still and often leads to getting denied. If you or your loved one is applying for mental disability social security benefits, you should be aware of what likely factors could get your application rejected by the Social Security Administration (SSA). This way, you can prepare accordingly and limit your chances of getting denied. Late Diagnosis of Mental Conditions A mental disorder doesn’t always appear obvious. As a result, many individuals get diagnosed late. They struggle to keep jobs and would often have an odd work history. Since benefits can only be received by people who have paid into the system through paycheck deductions, this is often a problem. Many even qualify for very little amounts under Social Security Disability compared to those with obvious physical impairments.

Wednesday, August 26, 2015

Combating Claims Denial Now That Eligibility for Medicaid Has Expanded

Medicaid expansion under “Obamacare” is considered one of the biggest milestones in U.S. healthcare. It reaches out to the country’s poorest, covering almost half of all uninsured Americans. More people in states that have expanded Medicaid can now benefit from free or low-cost healthcare provided they meet certain income requirements, regardless of their family status, disability, and a lot of other factors that are typically considered in evaluating eligibility for Medicaid. In the medical community, Medicaid expansion has garnered different reactions. The government agency is notorious for taking a long time to pay claims and for denying claims frequently. Additionally, some doctors even claim to be paid less than the actual cost of their services. It’s no surprise, therefore, that with all these reimbursement concerns, many physicians have avoided taking Medicaid patients even before the passage of the act.

Tuesday, August 25, 2015

Revenue Cycle Management Companies Can Make Healthcare More Efficient

To keep your healthcare facility running, quality service must be backed up with profitability. To ensure that adequate revenues are getting into your cash flow, a revenue cycle management system must be set in place. Knowing what is revenue cycle management (RCM) is just the first step; the more important step is managing your facility’s income generation activities from claims processing and payment collection up to revenue generation. This cycle starts by the time a patient calls for an appointment and ends once the account balance turns zero. Process automation is not enough Disorganized and inefficient workflow, coding errors, lack of staff training—these are just some of the many factors that hinder optimal RCM productivity. Although there is software that let you effectively monitor the claim process, maintains that using them would be wasteful if you don’t eliminate fundamental problems prior to the implementation of said programs.

Monday, August 17, 2015

Why You Should Check Your SSI Claim Status

It’s easy to think that all you have to do is wait once you’ve accomplished all forms and handed them all to the SSA. The truth is you can’t relax just yet, not at least after you get approved. Many things can go wrong while your claim is being processed—errors can end up delaying your claim’s approval, which could put all your hard work to waste and send you right back to square one.

Wednesday, August 12, 2015

Senior Medicaid Eligibility and Long Term Care

Need financial assistance for nursing home or assisted living services? Medicaid can provide you with the needed finances through its Long Term Care program, designed for low-income seniors with limited assets other than the home they own. It can pay for almost all of your care needs, provided you are qualified.

Tuesday, August 4, 2015

What are RCM Best Practices for Denial Handling?

With more patients relying on the government to supplement their healthcare needs, every medical facility’s viability depends largely on effective revenue cycle management (RCM). One of the most important phases of RCM is denials resolution; a facility can lose thousands of dollars each year if they don’t appeal denials. This article will serve as a brief guide for billing officers: