Expert Insights for Healthcare Organizations: Navigating Insurance Changes in 2024
New insurance regulations that could impact your healthcare organization. Stay ahead with effective, easy to implement solutions
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Dec 19, 20234 min read
Maximizing Reimbursement: Tips for Behavioral Health Providers Facing Record Requests and Retroactive Terminations
Behavioral health providers may have noticed an increase in medical record requests from HCSC (Health Care Service Corporation) Blue...
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Nov 16, 20232 min read
Maximizing Revenue: Tips on Collecting Deductibles, Coinsurance and Copays
To improve your bottom line, it’s not just the insurance companies you’ll need to follow up with for payment; you have to stay on top of...
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Oct 20, 20231 min read
Healthcare Should NOT Be a Privilege
This week, a viral Instagram post highlighted a major problem with the US healthcare system. In a since modified post on Instagram,...
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Feb 23, 20234 min read
Why it is increasingly critical to collect patient copays, deductibles and coinsurance.
Member policies are shifting We are seeing much higher deductibles for in and out of network policies. This means that the client will...
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Dec 1, 20223 min read
Employers Posed to Expand Mental Health Coverage for 2023
Employers are looking to enhance their mental health care and other benefits for employees in the coming year. New research shows...
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Oct 16, 20221 min read
Improve Patient Intake to Better Manage Your Revenue Cycle
Gathering the correct information during an intake assessment or pre-screen is essential to insurance reimbursement. Use our checklist...
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Oct 16, 20223 min read
7 Things to Look For in a Medical Billing Company
Outsourcing or changing billing companies can be a lot of work. In fact, many providers stick with a mediocre billing service simply to...
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Oct 16, 20221 min read
4 Things You Should Know Before Calling for a Prior Authorization
Utilization Review Utilization Reviews bridge the gap between providers, payors and patients. They give the provider the opportunity...
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Oct 16, 20222 min read
5 Steps to Get Aging Claims Paid
No matter how thorough your billing process is, every provider has a list of claims that seem impossible to get paid. Overturning claim...
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Oct 16, 20223 min read
4 Simple Things You Should Do to Correct Claim Denials
Dealing with insurance companies can be a pain. Whether you are a patient or provider, it is difficult to understand how insurance works,...
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Oct 16, 20222 min read
Increase Your Behavioral Health Revenue by Collecting Old Receivables
Collect on Unpaid Claims Many facilities and medical practices have a number of denied insurance claims that are not actively being...
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Oct 16, 20222 min read
5 Tips to Minimize Prior Authorization Delays
What is Prior Authorization? Prior authorization is almost always necessary for behavioral health treatment. Once your authorization team...
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Oct 16, 20221 min read
How to Use ASAM Guidelines to Get Authorization
What is ASAM? ASAM (The American Society of Addiction Medicine) Criteria is the most common set of guidelines that payors and providers...
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Oct 16, 20222 min read
How to Prove Medical Necessity to Reverse a Claim Denial
Medical necessity is one of the most common reasons that insurers deny behavioral health claims. It is possible to get this type of...
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Oct 16, 20221 min read
How to Prepare for a State Agency Visit
Providers and facilities of all specialties are subject to inspections from the Department of Health Care Services (DHCS). Auditors...
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Oct 16, 20222 min read
The Most Effective Way to Write an Insurance Appeal Letter
Do you get authorization prior to treating a patient, yet still receive claim denials? This is a common issue that providers face on a...
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Oct 16, 20222 min read
USE A BUSINESS ASSOCIATE AGREEMENT FOR HIPAA COMPLIANCE
Why Use a Business Associate Agreement? Because healthcare providers frequently outside vendors and subcontractors, it is important to...
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Oct 16, 20222 min read
UNDERSTANDING THIRD-PARTY PAYER AUDITS
Third-Party Payer Audits As the value-based care model gains momentum in U.S. healthcare, payer audits by third-party vendors are...
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Oct 16, 20224 min read
Applying Value-Based Care to Behavioral Health
In last week’s blog, I talked about third-party payor audits and what they mean for your behavioral health facility. Before writing the...
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