HR Advisor for Organizations aspiring growth, Campus Placement Trainer and Visiting Faculty at Premier Management Institutes in Mumbai, MAM from JBIMS with more than 3 decades of IT Industry Experience.
Is your medical claim stuck? How to avoid delay in settlement https://lnkd.in/d_92376G Download Economic Times App to stay updated with Business News - https://lnkd.in/eK4XZsX #HealthInsurance #MedicalInsurance #Mediclaim
Navigating medical claims can be a complex process, and even small mistakes made by front-end staff can lead to costly rejections. Here are some common reasons for these rejections: Incorrect Patient Information - Simple errors like misspelling a name or entering the wrong date of birth can lead to immediate claim rejection. Incomplete Forms - Missing information such as patient demographics or insurance details can halt the claim process. Eligibility Issues - Failure to verify a patient’s insurance coverage can cause rejections due to ineligibility. Wrong Insurance - Selecting the wrong insurer will result in claim denial. Ensuring accuracy and thoroughness in these areas can significantly reduce the chances of claim rejections and improve your revenue cycle management. Interested to read further about this? Explore our latest blog on this topic, featuring tips for making improvements: https://zurl.co/x3bD #RevenueCycleManagement #MedicalBilling #MedicalPractice
Integrating a digital COB solution within registration and scheduling workflows can help providers ensure they bill primary and secondary payers correctly, preventing unnecessary claim denials
https://lnkd.in/g2RF9NUU I am so glad that this is being brought to the surface. I don't think that many people realize the tactics used by such companies to get themselves richer at the expense of common people's welfare. In my own professional life there was a time that I accepted almost all managed care insurances. However, soon I realized that they not only were greatly reducing my compensation but (more importantly) these companies were fighting against my providing care to their members. They started imposing arbitrary limits on the number of sessions allowed. To get more sessions authorized one had to fill out extensive forms and wait on the phone to talk to their utilization managers. Imagine trying to make a living having your fees cut in half and you have to spend half your days not being paid anything so you can try to argue for more care for their member to get the help that was needed. Probably some of you experienced this. The thing was that when someone like me complained about this it seemed like we were whining. Meanwhile, the insurance companies kept saying they were containing costs for the consumer or universal care or whatever it was they claimed while paying their executives multimillion dollar compensation etc. The beautiful thing about this story is the consumer themselves can see how these companies are cheating them - not me as the provider - but them and their elderly parents. Ultimately, I went outside of the networks. I stopped taking Medicare and all managed care insurances, instead limiting my practice to out of network PPO insurances. I do this for more than my own interests but also for the interests of my clients. Unfortunately, these insurance companies will continue to cheat both the patients and the providers until we all refuse to be part of their systems which stack the deck in favor of themselves.
This is such an interesting and important subject.
https://lnkd.in/g2RF9NUU I am so glad that this is being brought to the surface. I don't think that many people realize the tactics used by such companies to get themselves richer at the expense of common people's welfare. In my own professional life there was a time that I accepted almost all managed care insurances. However, soon I realized that they not only were greatly reducing my compensation but (more importantly) these companies were fighting against my providing care to their members. They started imposing arbitrary limits on the number of sessions allowed. To get more sessions authorized one had to fill out extensive forms and wait on the phone to talk to their utilization managers. Imagine trying to make a living having your fees cut in half and you have to spend half your days not being paid anything so you can try to argue for more care for their member to get the help that was needed. Probably some of you experienced this. The thing was that when someone like me complained about this it seemed like we were whining. Meanwhile, the insurance companies kept saying they were containing costs for the consumer or universal care or whatever it was they claimed while paying their executives multimillion dollar compensation etc. The beautiful thing about this story is the consumer themselves can see how these companies are cheating them - not me as the provider - but them and their elderly parents. Ultimately, I went outside of the networks. I stopped taking Medicare and all managed care insurances, instead limiting my practice to out of network PPO insurances. I do this for more than my own interests but also for the interests of my clients. Unfortunately, these insurance companies will continue to cheat both the patients and the providers until we all refuse to be part of their systems which stack the deck in favor of themselves.
The Dangers of AI
https://lnkd.in/g2RF9NUU I am so glad that this is being brought to the surface. I don't think that many people realize the tactics used by such companies to get themselves richer at the expense of common people's welfare. In my own professional life there was a time that I accepted almost all managed care insurances. However, soon I realized that they not only were greatly reducing my compensation but (more importantly) these companies were fighting against my providing care to their members. They started imposing arbitrary limits on the number of sessions allowed. To get more sessions authorized one had to fill out extensive forms and wait on the phone to talk to their utilization managers. Imagine trying to make a living having your fees cut in half and you have to spend half your days not being paid anything so you can try to argue for more care for their member to get the help that was needed. Probably some of you experienced this. The thing was that when someone like me complained about this it seemed like we were whining. Meanwhile, the insurance companies kept saying they were containing costs for the consumer or universal care or whatever it was they claimed while paying their executives multimillion dollar compensation etc. The beautiful thing about this story is the consumer themselves can see how these companies are cheating them - not me as the provider - but them and their elderly parents. Ultimately, I went outside of the networks. I stopped taking Medicare and all managed care insurances, instead limiting my practice to out of network PPO insurances. I do this for more than my own interests but also for the interests of my clients. Unfortunately, these insurance companies will continue to cheat both the patients and the providers until we all refuse to be part of their systems which stack the deck in favor of themselves.
#ElevanceHealth looses more #MedicareAdvantage Stars (and thus bonuses) than anyone. Sues the grader (#CMS). Doesn't like the more stringent post-#COVID grading curve. Victim of "TukeyGate" outlier adjustment. Could cost #Elevance $500M. Elevance also claims the secret shopper program is costing it another $190M in bonus payments because of a poor grade on translation services based on a single phone call(!) Elevance says the concerning $190M phone call never took place. #Healthcarequality #PublicPrivatePartnership #PublicPrivatePartnerships
Transparency is key when it comes to discussing the use of weight loss drugs during paramedical exams. At APPS of Georgia, we're here to guide applicants through the process with accuracy and integrity. #ParamedicalExams #HealthHistory #InsuranceProcess https://loom.ly/RNhD97c
What does the policy cover? Make sure you understand exactly what expenses the policy will cover. This could include funeral costs, medical bills, outstanding debts, etc. Are there any age restrictions or health exams? Some policies might have age limitations or require medical exams. Clarify if these factors will affect your eligibility or the cost. Is There a Waiting Period? Some policies might have a waiting period before they provide full coverage. Make sure you know the terms regarding this. These are 3 important questions to ask. Be sure to save this post & when you're ready give me a call to go over your options for a policy. Dr. Ruama Camp Final Expense Specialist (832) 642-1554 Click the link in the bio to snag my contact card or save it: https://lnkd.in/gBTgBPgh #queenoflifeinsurance #LifeInsuranceMatters #lifeinsurancepolicy #lifeinsuranceagent #finalexpensespecialist #finalexpenseplanning
NEW BLOG POST 📣 Understand why collecting patient payments can be challenging for family practices, and learn how you can overcome them and provide better care.
