Healthcare News
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UnitedHealthcare to terminate contracts with some providers
2/9/2022
New York Providers, This month, United Healthcare sent contract termination letters to all providers having active privileges at Northwell Health’s Hospital, effective March 2022!Those providers affected by the termination with the UHC Medicaid plan who want to remain in the network...
Everything you need to know about The 21 Century Cures Act
2/8/2022
If you are a mental health provider, you have probably heard about the 21st Century Cures Act, signed by President Obama back in 2016. Among numerous aspects, this legislation focuses on providing greater access to mental health services. In addition, one of its main aims is to minimize healthcare i...
NCD vs. LCD - what's the difference?
2/6/2022
Did you know that there are two types of Medicare reimbursement policies?When a Medicare Administrative Contractor makes a ruling as to whether a service or item can be reimbursed, it is known as a local coverage determination (LCD). It is always based on medical necessity and is valid only in the c...
Regulations to look at in 2022 – an overview
2/1/2022
COVID-19 still remains a central topic of discussion among
healthcare professionals today. However, there are some other aspects of equal
importance that you need to look at in 2022, such as:
The No Surprises Act New rules of info...
Hiring new employees? Read this first
1/30/2022
Planning to expand your private practice? If so, you are probably concerned about how to find & accommodate new employees to their positions at your office. When new personnel is employed, many medical practices follow a structured procedure that lasts until the employees are socialized int...
How to maximize the revenue of your radiology practice
1/27/2022
Did you know that 10% of outpatient radiology services are underpaid or denied? According to our internal research, services performed by radiologists are among those for which insurances request medical records most frequently. Why wouldn’t they, considering how complex and costly many i...
Are you ready for a new CAHPS survey?
1/25/2022
Did you know that the CMS conducts various patient satisfaction surveys each year?Most of such surveys are in the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) family of surveys, overseen by the Agency for Healthcare Research and Quality (AHRQ).CAHPS surveys ask patients to r...
Behavioral health provider credentialing
1/23/2022
Are you a mental health provider planning to enroll with some insurance payers?Did you know that payer enrollment is complicated process that can take up to 180 days to be completed? Moreover, healthcare providers also have to dedicate lots of their time & effort on preparation of each applicati...
How to indicate the difference between a new and an established patient
1/20/2022
Insurance payers want practitioners to be as precise as possible. Did you know that about 10% of claim denials for outpatient office visits occur because providers fail to indicate whether a patient has already visited their office before or not?The CPT guidebook defines a new patient as “one ...
Out-of-network services performed during the PHE
1/18/2022
Since the beginning of the COVID-19 pandemic, many insurance payers have lifted or reversed their reimbursement policies. For example, some out-of-network services are temporary payable by various commercial, HMO and Medicare/Medicaid advantage plans. In New York, COVID-19 vaccine administration is ...
How to report COVID-19 vaccine side effects
1/16/2022
With over half a million cases currently reported in the US every day, the COVID-19 pandemic is far from being over. A constant feeling of responsibility mixed with a trivial fear of getting sick from yet another new variant of the virus has encouraged millions of Americans to get a jab.As safe as t...
Credentialing and privileging of hospitals providing telemedicine services in New York
1/11/2022
The COVID-19 pandemic has been ongoing for nearly two years already. With businesses choosing between going fully remote or bankrupt, healthcare providers opt in to perform more telemedicine services than ever. Surprisingly, hospitals are taking the lead. In 2022, treatment cooperation between so-ca...
Psychiatrists, here is why you should pay attention to the No Surprises Act
1/9/2022
Are you a psychiatrist treating uninsured or self-pay patients? If so, you are now required to provide a good faith estimate (GFE) of costs of your services to such patients. Pursuant to the No Surprises Act, healthcare providers must reveal an estimate of expected charges for a certain service or a...
Everything you need to know about insurance panels
1/3/2022
Enrolling with an insurance payer is quite a complicated and
time-consuming process. Healthcare providers normally have to wait for up to 4
months to become a participating provider with an insurance payer.
An insurance panel (or “a payer panel”, “an enrollment
...
How to deal with the forms requested by insurance payers
12/28/2021
Insurance claims billing and collection is an extremely complicated process.
Medical providers and their staff constantly have to make sure that their payer claims are paid by insurance carriers, let alone paid appropriately. While payers
rush to make their clinical reimbursement poli...