New insurance regulations that could impact your healthcare organization. Stay ahead with effective, easy to implement solutions

Behavioral health providers may have noticed an increase in medical record requests from HCSC (Health Care Service Corporation) Blue...

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...

This week, a viral Instagram post highlighted a major problem with the US healthcare system. In a since modified post on Instagram,...

Member policies are shifting We are seeing much higher deductibles for in and out of network policies. This means that the client will...

Employers are looking to enhance their mental health care and other benefits for employees in the coming year. New research shows...

Gathering the correct information during an intake assessment or pre-screen is essential to insurance reimbursement. Use our checklist...

Outsourcing or changing billing companies can be a lot of work. In fact, many providers stick with a mediocre billing service simply to...

Utilization Review Utilization Reviews bridge the gap between providers, payors and patients. They give the provider the opportunity...

No matter how thorough your billing process is, every provider has a list of claims that seem impossible to get paid. Overturning claim...

Dealing with insurance companies can be a pain. Whether you are a patient or provider, it is difficult to understand how insurance works,...

Collect on Unpaid Claims Many facilities and medical practices have a number of denied insurance claims that are not actively being...

What is Prior Authorization? Prior authorization is almost always necessary for behavioral health treatment. Once your authorization team...

What is ASAM? ASAM (The American Society of Addiction Medicine) Criteria is the most common set of guidelines that payors and providers...

Medical necessity is one of the most common reasons that insurers deny behavioral health claims. It is possible to get this type of...

Providers and facilities of all specialties are subject to inspections from the Department of Health Care Services (DHCS). Auditors...

Do you get authorization prior to treating a patient, yet still receive claim denials? This is a common issue that providers face on a...

Why Use a Business Associate Agreement? Because healthcare providers frequently outside vendors and subcontractors, it is important to...

Third-Party Payer Audits As the value-based care model gains momentum in U.S. healthcare, payer audits by third-party vendors are...

In last week’s blog, I talked about third-party payor audits and what they mean for your behavioral health facility. Before writing the...