Search
Credentialing Blog Series Part 2 of 4: Pitfalls to Avoid!
Main Points What is credentialing What are the steps in credentialing What are the pitfalls to avoid Next, you will need to understand the basic process for credentialing in order to apply the terms you have learned above. Here are some frequently asked questions about credentialing and their answers: What is Credentialing: Credentialing, paneling, or payer enrollment is the process of showing and proving your credentials to an insurance company for the purpose of seeing pati
Credentialing Blog Series Part 1 of 4: What you will need to successfully credential!
Main Points Terms The complete list of information you will need to credential with insurance companies Navigating credentialing is a lot like wading through concrete. It can be a long and slow process, but there are actions you can take in order to be as prepared as possible. In this credentialing mini-series, we will go through the credentialing process and the information that you will need in order to be successful at credentialing. First, you will need to know some key t
How To Explain A Balance to a Patient
Main Points Be Clear Be Concise Be Constructive The reality of high deductible health plans (HDHPs) is still setting in. Patients are choosing to pay less in monthly premiums in exchange for HDHPs, but this places more of the financial burdens on the patient when it comes to paying for health care. This strategy is called assuming downside risk. This means that they pay lower premiums but the downside is that they will pay more in health services. Due to more patients assumin
Psychological Testing Codes vs. Neuropsychological Testing Codes
Main Points Why did the codes change in 2019 Definitions of the codes simplified The feedback codes vary between psychological and neuropsychological tests The change to the new testing codes in 2019 caused quite an uproar in the testing and psychological community. The last change we saw a change to the testing codes was in 2014 when 96101, 96105, 96116, 96118, and 96125 were introduced. However, after CMS evaluated the reimbursements based on these codes they found that re
So, You Want to Go Into Business With Your Spouse...
Main Points Create a shared goal with your spouse Play to your individual strengths Endurance and grittiness are key “What is it like being Jeremy’s assistant?”… is one of the most abhorrent questions Kathryn is asked on a regular basis. We tell people that we own a business and people assume that I am “in-charge”, “steer the ship”, and “run the show”. The truth of the matter is that my wonderful wife, Kathryn, is as much a leader if not more. When we decided to go into busin
Get Paid with Accurate Patient Records!
Main Points Collecting all the information you need from your patients will help you to keep accurate records and collect from them what you need to Patient demographic information is the first step to successful reimbursement Patient demographic information is important to ensure compliance in the revenue cycle process Getting a new patient inquiry is very exciting! A new patient inquiry is evidence that your marketing efforts are working and now you have an opportunity to u
The Complete Checklist for Eligibility and Benefits Checks
Getting benefit information is important for the success of your practice
What is a CMS 1500 Form?
Main Points: What is a CMS 1500 Form What do all the boxes mean In the United States Healthcare system there are actually two types of claim forms. There is a CMS 1500 form and a UB-04 form. The claim form system was developed to help identify the procedures being performed on patients and who was performing them, however, this is a difference between hospital services and professional outpatient services. This is why there are two kinds of claim forms. A CMS 1500 form is the
3 Reasons Why Your Biller Needs to See Your EOBs (Explanation of Benefits)
Main Points Your biller needs your EOBs so they can follow up on denials in a timely fashion Your biller needs your EOBs so they can make sure the insurance companies are paying you what you deserve to be paid Your biller needs your EOBs so they can reconcile your A/R There can be some concerns about sending EOBs through email or through an encrypted portal. It is reasonable to be concerned about data breaches, stolen personal data, or HIPAA non-compliance. However, it is ver
What is an Aging Report and Why is it Useful?
Main Points An aging report is a high-level overview of the outstanding money owed to a practice It is useful because it gives you a picture of the health of a practices processes Accounts Receivable (A/R) is the money owed to your practice by patients and insurance companies. The A/R process begins when the session with the patient is over and is closed when that session's balance comes to $0.00 from the insurance company and from the patient. Because the success of a practi
