Payers

Each day we learn more about how payers are processing claims. Here's what your medical practice needs to know.

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

The CBO says tacking a five-year delay to the individual mandate to the SGR fix will result in 13 million more uninsured and cost $138 billion.

If it were possible to predict insurance payments, I wouldn’t be so overwhelmed by appeals and take backs.

Any way you look at it, the hope that individuals will actually buy into the private purchase of health plans seems largely misplaced.

Insurance companies are being sneaky about keeping your money. Here are some of those secrets they'd rather you not know, and what you can do about it.

Here are eight questions your medical practice should be asking when it comes to testing your claims submissions for the upcoming ICD-10 transition.

Some patients are disqualified from help obtaining health insurance coverage because they simultaneously earn too much, and too little.

Performance, not a physician's resume, is fast becoming the new gold standard for patients and payers alike.

Fallout from the ACA has been shocking to many medical practices who really didn't see what was coming. What you can do about it today.

RemitDATA's chief operating officer, Brian Fugere, explores the most common unexpected denials at medical practices nationwide, with a focus on pediatrics.

As a physician, the decision to participate in new healthcare exchange plans may not be up to you. Make sure you understand all the nuances.

Whether a physician is liable for an overpayment is not determined solely by whether such action is attributable to that physician.

You might be surprised to find out that you are out of network for many of the new health plans.

If Medicare cuts become too cumbersome - independent physicians, employed physicians, and patients will suffer.

Medical practices face increasing difficulty collecting from payers, but off-loading the burden to patients is a big mistake.

Many physicians have been dropped from United Healthcare's Medicare Advantage plans, and many doctors are worried that other payers will begin following suit.

A government takeover of healthcare would affect more than availability of care. It would affect how healthcare providers respond to meet consumer expectations.

Here are three initial steps physicians should take if they find themselves on the receiving end of a payer letter indicating they are being dropped from the network.

The ACA is creating a middle class that is underinsured, threatening to undermine physicians' ability to improve population health, and to be rewarded for it.

Dallas County Judge Clay Jenkins explains the true cost of uncompensated care and how a healthcare reform coalition is aiding Texas patients and physicians.

For the January edition, RemitDATA's chief operating officer, Brian Fugere, explores the most common unexpected denials, with a focus on orthopedics.

It's time to take patient collections out of physicians' practices to truly have patients make responsible choices about their healthcare dollars.

Texas is a prime example of a state refusing federal funding for Medicaid out of misplaced principals that in the end hurt access to care.

Thanks to the Affordable Care Act, all claims filed under government plans are now on equal footing with ERISA-governed health plan claims.

While selling your medical practice and becoming a hospital employee has its drawbacks, it also comes with many perks.

While both organizations focus on shared savings and greater efficiencies of care, they are not mutually exclusive.

The 2014 Medicare Physician Fee Schedule notes preliminary guidelines for receiving separate payment for chronic care management services, beginning in 2015.

No matter the roadblocks your practice will face this year, especially the ICD-10 transition, a robust financial reserve at year's end will help.