The No Surprises Act Is Now In Effect

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By: Winona Thomas BS HCS The federal No Surprises Act establishes new requirements for healthcare providers, facilities, and providers of air ambulance services to protect consumers from “surprise” medical bills. What are the impacts to healthcare providers with this new act in place for 2022? Previously, when the provider office received a payment as an out-of-network payment from the payer, the typical … Read More

Facility Credentialing Process in MN

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By: Ann Knutson, CPC-A Facility credentialing is a critical aspect of healthcare revenue cycle management. This is the process in which an insurance carrier evaluates a facility for approval to be ‘in network’ and a participating provider of specific healthcare services. According to the Minnesota Department of Health: “Credentialing is the process used to determine if an individual practitioner and/or … Read More

Reduce Your Denials With These 4 Tips

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By Ranadene Tapio, MBA, CMRS, CPCS   Your practice seems to be doing everything right. You have a team in place, you’ve established your Revenue Cycle Management (RCM) process and you’re submitting claim after claim – but your denial rate isn’t going down. According to the American Academy of Family Physicians (AAFP), the average denial rate is between 5-10 percent. The result is the delay or cancellation of new practice initiatives that … Read More

Medical Necessity and the Revenue Cycle

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By Ann Knutson, CPC-A According to the Center for Medicare & Medicaid Services (CMS), medical treatment or supplies provided by a physician is considered medically necessary when they “are proper and needed for the diagnosis or treatment of your medical condition, meet the standards of good medical practice in the local area, and aren’t mainly for the convenience of your … Read More