Healthcare News

WCH is committed to the success of our clients. For over 20 years, we have been resolving thousands of claim denials and underpayments directly with various insurance companies and other payers. At the same time, we have helped our clients tackle issues related to their insurance contracts or absenc...

In recent months, our experts have witnessed a significant increase in claim denial rate of our prospective and existing clients. Insurance carriers have taken up a tendency of denying payment for services for no medical necessity. Surprisingly, even regular office visits have been affected. In addi...

At some point, many of us have wondered if there is "a secret formula" that eliminates all claim denials and instantly rises a reimbursement rate to 100%.The truth is – there is none. However, there are still some effective methods that can significantly decrease your claim denials. We...

Since the early days of the COVID-19 pandemic, telemedicine has become an essential way to render health care to everyone in need all over the world. By implementing various virtual care solutions, healthcare providers have kept their businesses up and running, while also keeping their patients and ...

If you are an outpatient healthcare provider, you have probably collected an outstanding balance from a patient at least once. Most of such collections involve getting funds for your patients’ deductibles and coinsurance. However, in some cases, insurance payers do not reimburse for a full cha...

Medical billers and coders are critical to revenue cycle management, thus having a skilled and high-performing workforce is critical to running your medical practice smoothly and successfully. Medical billers submit and follow up on claims with insurance companies in order to get paid for services p...

Commercial payers and Medicare/Medicaid alike often require healthcare providers to ask for approval prior to rendering a service. A prior approval, or authorization, is a payer’s allowance to perform a procedure on a particular patient given to a healthcare provider. Such approvals are n...

HIPAA stands for “The Health Insurance Portability and Accountability Act”. It is a set of standards regulating the privacy of patients’ Protected Health Information (PHI). The act was introduced by the U.S. Congress in 1996. The purpose of this federal regulation is to ensure the ...

As it is currently with nearly all medical specialties, getting paid flawlessly is a challenge in podiatry. Newly-introduced podiatry coding guidelines, combined with an increasing number of patients, make it harder for physicians to receive fair payments for their services.Podiatry medical billing ...

Still have no contracts with some insurance payers? While out-of-network payment rates may be attractive, insurances are still quite “peaky” when it comes to quality assurance. However, having no enrollment contact does not mean facing no recoupments.According to internal research done b...

If you are a physician working at a private medical facility, you may be cooperating with your colleagues when it comes to determining a patient’s clinical condition and subsequent methods. Did you know that the CMS pays for split evaluation and management services perform...

Documenting your patients’ clinical conditions is an extremely tough, but important process. The CMS and commercial payers require you to indicate the desired medical necessity in a maximum level of detail in the medical records and on insurance claims of each patient. The latter process inclu...

Mental health is extremely important. This “umbrella” specialty of medicine deals with the issues that directly impact how we think, feel, and cope with our lives. As a result of all the stressful events currently experienced by billions of people all over the world, the dema...

Since the early days of the COVID-19 pandemic, telemedicine has become an essential way to render health care to everyone in need all over the world. By implementing various virtual care solutions, healthcare providers have kept their businesses up and running, while also keeping their patients and ...

Being a healthcare professional is a challenging mission. Every day, most of you have to balance between saving lives and dealing with the issues related to payments. With that in mind, you are obviously familiar with the aspects like claim denials, recoupments, and payer crede...