Healthcare News

Thanks to the COVID-19 pandemic, most of us have started spending even more time looking at flat screens of our smartphones, laptops, and computers. No matter how hard it may sound to believe, vision care service providers are currently in exponentially increasing demand thanks to a pandemic that is...

Are you out-of-network with the plan but still want to accept a patient?Non-contracted practitioners can be reimbursed quite well by insurance if certain conditions apply. There are several important things to know prior to performing any service in such cases.First, it is critical to check if the p...

At WCH, we care about your practice. Our billing and credentialing experts offer an all-inclusive package of services for you to maximize your reimbursement flow. We aim to provide top-quality assistance to our clients, that is why we assign individual account representative(s) to each of you. Your ...

MUE (Medically Unlikely Edits) is the maximum number of units of service allowed, under most circumstances, for the same provider on the same date of service for the same patient.MUEs affect hospital outpatient departments, physicians and non-physician practitioners, and durable medical equipment (D...

Insurance coverage information is often confusing. Some of your patients may have coverage with up to 4 insurances or benefit plans. For example, Mary may have an active plan with both Medicare and Medicaid, Aetna, and Empire Blue Cross Blue Shield. At the same time, Mark may be an active FidelisCar...

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...