Payers

Each year, athenahealth ranks payers on how easy they are to work with providers. Here are the company's top 5 for categories including Blues, and regional.

Here are strategies for surviving a potential surge in patients with Medicaid and high-deductible exchange plans.

It hasn’t dawned on Washington that hospitals and hospital systems will never commit financial suicide by reducing volume, and physicians will pay the price.

The "recredentialing trap," strict payment reviews, and fingerprinting are all underway or on the horizon as ways payers are bullying physicians.

Know who you can turn to when you are continuously denied payment by an insurance company so that your practice can get paid all that it is due.

If your practice is looking to boost its profitability and spend more time with patients, automating your billing and collections may be a solution. Here's why.

In medical practice, a cottage industry has developed, which is dedicated solely to legal “fault finding” without regard to equity.

Only one of five surveyed physicians cites reducing cost of care as a priority when that is every payer's first priority.

More practices and payers are tying a portion of physician pay to patient satisfaction scores. But it may come with unintended consequences.

Many articles describe the benefits of health reform, but look closely and it's clear that problems are mounting for physicians and the healthcare system.

Retail-based health clinics can help ensure patient access to care as more gain insurance, but they also raise price transparency and reimbursement issues.

If you participate in quality care programs be sure you have a good understanding of your data. Otherwise you could lose out on potential revenue from payers.

RemitDATA's director of product management, Aaron Hood, explores the most common unexpected denials at practices nationwide, with a focus on internal medicine.

If we hope to reduce Medicare spending, how about we ask physicians for important strategies vs. just ensuring expensive equipment is used properly.

Why CMS should do away with hospital-led ACOs, and instead, focus on physician-led ACOs.

Consultant Gail Levy shares nine steps to ensure your practice is orienting new patients efficiently and effectively.

Payers are using deceptive methods to get medical practices to accept low rates and new plans. Don't fall into the trap.

Bundling payments for care episodes is gaining popularity among payers. It is episodic risk-sharing, and it can be risky business for physicians.

New rules will now require Medicare enrollees who are classified as “high risk,” to subject themselves to fingerprint-based background checks.

If the government can make it appear that doctors are getting rich from Medicare payments, it will be easy to garner support to cut physician payments in the future.

The Obama administration’s health insurance enrollment numbers don’t match up to a conservative’s fact check. Who is telling the truth?

Here are five key points about Medicare Advantage plans to answer questions and clear up misinformation for physicians.

Workers' compensation carriers are banking on the fact that at some point medical practices will give up and walk away.

Whether your medical practice was ready to implement ICD-10 in October 2014 or not, here's what you need to do to get ready for the transition in 2015.

Physicians and medical practice staff must be able to differentiate between preventative and diagnostic services in order to avoid a loss in revenue.

Sometimes insurance companies get between patients and their physicians; especially this time of year when health plans make changes.

The 90-day “payment grace period” for exchange insured patients puts physicians at risk for 60 days if patients don't pay their premiums.

Does your practice have an ICD-10 transition plan? Don't forget about prior authorizations.

More than 5 million Americans have signed up for private health plans through the health insurance exchanges. Is your medical practice feeling the effects?

Payers know that correctly writing down every patient encounter is difficult for physicians, if not impossible. Therefore, exploiting this is easy for them.