What is the ERISA appeals process, and why is it important?
Insurance companies conduct business based on the premise that their policies are the last word on whether they pay or deny a healthcare claim. This assumption, however, is false. The…
The Healthcare Industry Sees More Up and Downs in the Wake of Covid-19
Things have been turbulent lately in the healthcare industry, mostly thanks to the Covid-19 pandemic. Some days, things go well and hospital systems bring back employees who were formerly furloughed.…
What Do Coronavirus and ERISA Recovery Have in Common?
Recent reports of the Coronavirus have American’s in a state of panic. Although the illness hasn’t reached pandemic levels yet, many people – healthcare professionals included – are preparing for…
More Hospital Closures on the Horizon
As we’ve discussed before, healthcare facility closures occur on a regular basis. Sinc the beginning of 2020, five different provider groups and one manufacturer have filed for bankruptcy. Since the…
ASC’s Are on the Rise Despite the Potential For Billing Issues
According to a recent study, the number of patients going to ambulatory surgery centers, also known as ASC’s went up in the past year. While those numbers don’t exactly corroborate…
The State of the Industry: Seven Predictions For 2020
Every year, industry predictions are made based on studies completed during the last year. According to experts, seven important healthcare industry segments will get larger in 2020. They fall into…
What Makes the Top Hospitals Truly the Best
The United States is known for having several well-known, world-renowned hospitals. All of them have a few things in common, including stable finances that allow them to expand and continue…
Strong Financial Systems Can Be Possible, According to These Health Systems
In a country where some hospital systems seemingly close overnight, while others thrive, it’s always good to hear about clinics and hospitals that are doing well. Whether they have a…
Issues With Updating Contracts Can Lead to Payment Issues
Several hospitals and commercial health insurance companies have been in the news lately as they attempt to work out new contracts. Although the articles have been clear that patients will…
The Importance of Collecting on Aged Claims
The truth is simple: aged claims get overlooked. Those in charge of the administrative side of healthcare often forget about them, because they make up such a small segment of…
How Much Do You Know About Revenue Cycles?
Those in the healthcare industry already know that revenue cycles are how the payments (i.e. revenue) from patients are tracked from the initial appointment through to collecting the portion of…
What You Need to Know About Aged Claims and Underpayments
According to recent statistics, commercial health insurance underpayments are on the rise. As of 2012, the payment accuracy rate for these insurance companies hovered around 62.08 percent. What does this…
What You Need to Know About Your Aged Out of Network Claims
Aged out of network claims are some of the most complicated commercial healthcare claims to collect on. Although these claims do fall under the Federal ERISA laws, they tend to…
Collecting on Aged Claims Can Prevent a Hospital Shutdown
What does your facility do with your aged claims? These claims may not seem like they add up to much in the grand scheme of things, but they can make…
Healthcare Operating Margins Are Thin So Utilize the Federal ERISA Process to Collect on Those Unpaid Claims
According to the experts, the expense growth rate for hospitals is steadily declining as time goes by. Some are predicting that by 2025, the expense growth rate will actually be…
Burdened With Out of Network Claims? Here’s How the Federal ERISA Process Can Help
Out of network claims are a major issue for many health providers. These claims need to be submitted properly to the commercial health insurance companies in order for them to…
Managing Payments With A Blockchain – How This Can Help Your CBO (Central Billing Office)
The CBO (Central Billing Office) of your hospital or clinic is in charge of sending commercial health insurance claims out to be paid. They also handle all of the other…
Underpayments and Analytics: How You Can Make the Billing Process Simpler
If your medical practice constantly deals with commercial health insurance underpayments, then you can utilize an interesting new method of examination in order to reduce them. This is called analytics.…
The Government Shutdown and Federal ERISA Appeals – What You Need to Know
Did the recent government shutdown have any effect on the healthcare industry? The correct answer here is that it did – and it may have led to a large backlog…
How Surgical Center Growth Leads to Billing Issues
Throughout 2018, a new trend emerged in healthcare – surgical centers. Although these centers, which are designed solely for outpatient surgeries, have been around for many years, quite a few…
Underpayments Are In The News Again: Here Are Your Options
Recent headlines include details on recent lawsuit won by Blue Cross Blue Shield (BCBS) over a series of underpayments on emergency room care in Texas. The lawsuit alleged that BCBS…
ERISA and Out of Network Billing Is in the News Again – Here’s What You Need to Know
Out of network billing is a huge issue for hospitals and clinics, because of the complications involved in the process. A recent law was signed into place in New Jersey…
We Have a Solution For Your Out of Network Underpayments
According to a recent article, commercial health insurance companies, also known as the “payers” in this situation, have been targeting out of network claims lately. This means that many of…
Improve Your Revenue Cycle and Prevent Claim Denials With These Tips
The revenue cycle is incredibly important to hospitals and clinics, many of which run on very thin margins. There are many things to pay for, including patient care, supplies, machinery,…
The Three CBO (Central Billing Office) Mistakes And How To Finally Get Those Claims Paid
Did you know that there are three common CBO (Central Billing Office) mistakes? When your hospital or clinic makes them, then you’re setting yourself up for future issues when it…
Two Important Facts In Getting Out of Network Claims Paid: A Clean Billing Process and Federal ERISA Appeals
Out of network claims are some of the most complicated commercial healthcare claims to collect on. Although these claims do fall under the Federal ERISA laws, they tend to go…
We Have a Final Payment Resolution For Your Underpayments
According to the experts, hospitals in the United States were saddled with 38.3 billion dollars worth of uncompensated care in 2016. This marked the first year in four where that…
We Have a Solution for the Results of Revenue Cycle Problems and Mismanagement
Some of the latest industry headlines center around revenue cycle management. This is a careful balance between sending out claims and appeals to commercial health insurance companies and patients while…
Healthcare Trends: Surgical Centers And Unpaid Commerical Health Insurance Claims
All around the country, surgical centers are popping up or getting purchased by larger networks. This is a very good thing for both patients and the health care system in…
Medical Appeals Make It Tough To Manage Hospital Finances In Today’s Climate
Managing your hospital’s finances is tough these days, thanks to things like medical appeals that usually end up on the wrong end of the balance sheet. In a perfect world,…
Everything You Need To Know About Collecting On Commercial Health Insurance Underpayments
Commercial health insurance underpayments are problematic. They occur when the health insurance company decides – for one reason or another – that it doesn’t need to pay your hospital or…
We Have a Solution for Those Lingering Commercial Health Insurance Claim Denials
Commercial health insurance claim denial percentages can vary. Some practices or hospitals only have to deal with a small amount of them – 5% for example. For others, that percentage…
What You Need To Know About Out of Network Billing and ERISA Appeals
Anyone who’s read the paperwork that comes with their health insurance policy is no doubt aware of the differences between in network and out of network appointments and procedures. These…
The Role Of The CBO (Central Billing Office) When Acquiring New Offices – How To Start Things Off With Few Unpaid Commercial Health Insurance Claims
Over the last ten years, countless physicians’ offices have been snapped up by hospitals and larger networks. These officers were added in order to simplify the provider process, which is…
How The Federal ERISA Appeals Process Can Get Your Hospital Out Of Financial Trouble
Federal ERISA appeals are one way that hospitals can recover money owed to them. Once those three state-level appeals are exhausted, it’s time for ERISA appeals. However, many hospitals aren’t…