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Why is Your Claim Not Processing?

By RMK HOLDINGS INC. | June 19, 2018

The majority of insurance carriers are mandated to deny or pay a claim within 30 days of receiving it. As a practice, you know you need to receive payment from the carrier (and the patient, for that matter) as quickly as possible. You also know this doesn’t always happen. Why? A Proactive Approach A few…

Key Differences: New Medicare ID Card

By RMK HOLDINGS INC. | May 17, 2018

In April of 2018 and continuing for one year, the Centers for Medicare & Medicaid Services (CMS) will launch new Medicare cards. Called Medicare Beneficiary Identifiers (MBIs), these new numbers will replace the current health insurance claim numbers (HICN) that are social security numbers. The idea is to help prevent Medicare fraud and help beneficiaries…

Collecting Deductible Resets and Patient Payments

By RMK HOLDINGS INC. | February 17, 2018

10 million consumers were in high deductible health plans (HDHPs) in 2010. Less than ten years later, 75 million are enrolled in these plans, a 650% increase. For you, this poses a challenge because patients usually ending up paying more out of their pocket for your services. Deductible Resets Deductible changes challenge patients and providers.…

Understanding the Medicare Advance Beneficiary Notice of Noncoverage (ABN)

By RMK HOLDINGS INC. | January 16, 2018

Also known as form CMS-R-131, applying the ABN when needed might be among the most misunderstood areas for Medicare providers. The purpose of the ABN is: If Medicare does not cover a service or treatment you have provided a patient, you can collect from the patient only if you have communicated the cost, that the…

Seven Ways to Stop Claim Denials

By RMK HOLDINGS INC. | December 18, 2017

With denials remaining a significant roadblock to full and timely reimbursement, and while denials occur across the revenue cycle, a high percentage are associated with eligibility, authorization and registration activities, all front-end processes. Consider these sobering industry statistics: Claim denials impact more than 3.3% of patient revenue 63% of denied claims are recoverable on first…

How to Stay Ahead of Collection Delays

By RMK HOLDINGS INC. | October 18, 2017

Ensuring payment is just as important as submitting a clean claim on time. Payments are delayed for many reasons resulting in the need to collect more aggressively. This is key since the collection process itself now demands more follow up labor expended than it did in the past. One would think because of technology advances…

Top Methods to Avoid Claim Denials

By RMK HOLDINGS INC. | October 1, 2017

The information below suggests reasons for and ways to avoid crippling your cash flow by effectively managing claim denials. The most common six reasons are: Exceeded time to file limits: With so many payors (the average practice uses 13) and different filing timelines a deadline is easy to miss. Know what your payor time limits…

How Many Opportunities Are Passing You to Collect?

By RMK HOLDINGS INC. | July 20, 2017

Insured patient costs have increased 256 percent between 2004 and 2014 according to a survey in 2016 by The Henry J. Kaiser Foundation. Assist your patients and team to quickly obtain payment and successfully close accounts while boosting patient satisfaction and overall experience. Know Thy Patient This means to find out everything possible about the…

Do You Have a Claim Rejection or Denial?

By RMK HOLDINGS INC. | June 21, 2017

A huge threat to receiving timely healthcare reimbursements are the dreaded claim rejections and claim denials. In addition, these are two phrases often used interchangeably in healthcare billing circles that shouldn’t be because they hold two different meanings. Understand the difference and adjust your workflow to reduce double work. Claim Rejections Claim rejections refer to…

How to Better Meet Patient Payment Expectations

By RMK HOLDINGS INC. | May 17, 2017

Some sobering numbers surfaced from a 2016 Black Book Market research survey. They surveyed 2,000 independent physicians and 200 hospital-based physicians. The results suggested that 90% or nine in ten small, independent practices are financially and technically challenged to implement value-driven care for patients. What exactly is value-driven care? This model is driven by delivering…

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