Florida Insurance Market Trends and Challenges The Florida insurance market has long been known for its unique challenges and trends. As a state prone to natural disasters such as hurricanes and floods, insurance providers in Florida have had to constantly adapt to the changing market conditions. In this article, we will explore the latest trends […]
As the saying goes, “health is wealth.” Indeed, good health is essential for living a happy and fulfilling life. However, maintaining good health can be challenging in today’s fast-paced world, where stress, pollution, and unhealthy habits are prevalent. The good news is that there are various health solutions that you can implement to improve your […]
Negotiating a fee schedule contract with a health insurance provider in the USA can be a complex process, but here are some general steps that you can follow: Research and Prepare: Gather information about the health insurance provider, including their current fee schedules, reimbursement rates, and other contract terms. Also, prepare your own data on […]
What are RVUs? RVUs (Relative Value Units) and conversion factors are used to calculate the reimbursement amount for medical services in the United States. RVUs are assigned to each service by the Centers for Medicare and Medicaid Services (CMS) based on the resources required to provide the service. The conversion factor is a dollar amount […]
The Merit-based Incentive Payment System (MIPS) is a program that is designed to incentivize healthcare providers to provide high-quality care to their patients. The MIPS program was established as part of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, which aimed to shift Medicare reimbursement from a fee-for-service model to a value-based care […]
The Merit-Based Incentive Payment System, or MIPS, is a program developed by the Centers for Medicare and Medicaid Services (CMS) that rewards healthcare providers for providing high-quality care to their patients. One of the key aspects of participating in MIPS is submitting data to the program. In this article, we will discuss how to submit […]
What is BCBSM and BCN ? Blue Care Network of Michigan is a subsidiary of Blue Cross Blue Shield of Michigan. It is a health insurance provider that offers various health insurance plans to individuals and families in Michigan. Blue Cross Blue Shield of Michigan is a non-profit health insurance company that offers a wide […]
Asthma is a chronic respiratory disease that affects millions of people worldwide. Allergic asthma is a type of asthma that is triggered by allergens, such as pollen, dust mites, pet dander, and mold. In this article, we’ll discuss the symptoms of allergic asthma, the treatments available, and what causes allergy. Symptoms of Allergic Asthma The […]
The process of billing claims and reimbursement is called “Revenue Cycle”.
What’s the Difference between these two? Credentialing Explained: Validating a healthcare provider in a private health plan and the approval to join the network is credentialing Enrollment Explained: While enrollment represents to the process of requesting participation in a health insurance network as a provider. Payor Enrollment, Credentialing Bringing new healthcare providers on board is […]
HCCs (Hierarchical Condition Categories) aren’t a new idea, but they didn’t attract wide interest until CMS began shifting more payment toward value-based programs, particularly MACRA, which affects clinician reimbursement. Organizations are rapidly shifting towards it. HCCs Explained: So there has been renewed interest in the concept. And it makes sense – without solid basic knowledge […]
Due to the growing number of payers, it has been noted that payment collection for emergency department and urgent care providers is getting more difficult. As a result, it appears that the breadth of the capacity of payment charges is decreasing. Particularly when elements like reimbursement, payer mix, and others are important to enhance the […]
