RMK HOLDINGS INC. specializes in fulfilling the resource gap after the medical claim is billed.
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?
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 avoid identity theft.
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.
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:
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.
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 this would not be the case but it is.