Business – MyQuerymed

09 Feb 2022

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HINT HEALTH ROLLS OUT A VALUE-BASED PRIMARY CARE DIRECT CONTRACTING NETWORK!

Direct contract physicians don’t submit claims because the care is not based on fee-for-service.

Hint Health is rolling out a nationwide network to provide direct contracting between employers and primary care providers, bypassing traditional insurance in the PCP market.

Hint Connect is providing employers a single point of access to hundreds of independent primary care providers, the company said.

It also removes the challenge for DPC practices to find and access large employers.

For physicians in direct primary care, “the challenge is getting to an employer-based that’s large enough,” said company COO Mark Nolan.

Hint Connect is currently rolling out across Texas in major metro areas and the Rio Grande Valley. Over the next three months, Hint Connect will expand to Colorado, Arizona, Oklahoma and Florida and will soon go nationwide.

WHY THIS MATTERS

Physicians like the simplicity and ability to operate partially or fully outside of the insurance-based system while having someone else take care of the administrative burden, Hint said.

Physicians don’t submit claims because care is not based on fee-for-service.

The HintOS platform automates enrollment, eligibility, invoicing, and payment. It offers direct-to-consumer membership management, Hint said.

Employers pay physicians a set monthly fee for each employee to receive primary care. The average cost is around $50 to $75 a month, according to Nolan.

Hint Health comprises 1,700-plus clinics, more than 5,700 employers and nearly a million lives. Its platform helps providers increase membership and saves money for employers, the company said.

28 Jan 2022

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A NEW BAN ON SURPRISE MEDICAL BILLS STARTS TODAY!

If you have a medical emergency, you will no longer need to worry about a large bill from a doctor you did not choose.

For years, millions of Americans with medical emergencies could receive another nasty surprise: a bill from a doctor they did not choose and who did not accept their insurance. A law that goes into effect Saturday will make many such bills illegal.

The change is the result of bipartisan legislation passed during the Trump administration and fine-tuned by the Biden administration. It is a major new consumer protection, covering nearly all emergency medical services, and most routine care.

“I think this is so pro-consumer, it’s so pro-patient — and its effect will eventually be felt by literally everybody who interacts with a health care system,” said Senator Bill Cassidy, a Republican from Louisiana, who was part of a bipartisan group of lawmakers who wrote the bill. He said he counted the bill as among his top achievements as a lawmaker.

Even with insurance, emergency medical care can still be expensive, and patients with high deductible plans could still face large medical bills. But the law will eliminate the risk that an out-of-network doctor or hospital will send an extra bill. Currently, those bills add up to billions in costs for consumers each year. Read more @ https://tinyurl.com/2p9wedyf

22 Jan 2022

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WHAT’S THE FUTURE OF MEDICAL BILLING LOOK LIKE?

Life was more leisurely in the 1980s. Most healthcare providers handled their own billing – physicians set fees for treatment and sent bills to insurance companies, who in turn paid the bill. Paper wasn’t a swear word yet, seeing as little technology was needed.

If you’re reading this, however, you know today’s healthcare world consists of rigid and complicated coding rules, and fees for each procedure endure an oft-heated negotiation process. The administrative burden is overwhelming for physicians, who more than ever are turning to medical billing companies for help.

Advances in health IT and the looming ICD-10 deadline are changing the rules of the medical billing game. Seeing as we’re living in an exciting time for medical billing, what lies on the horizon?

Let’s phrase this as that quintessential job interview question: where does medical billing see itself in the next few years?

Widespread EHR Adoption
We don’t expect it’ll take more than eight or so years for most American physicians to adopt an electronic health record. In 2011, the National Center for Health Statistics found that 55% of physicians had adopted an EHR system, and of course the 2015-16 Meaningful Use deadlines. Read more @ https://tinyurl.com/2nxj7tfp

18 Jan 2022

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WHAT IS MEDICAL BILLING?

3.01: INTRODUCTION TO MEDICAL BILLING

By now you have a good idea about the practice of medical coding. But we still don’t know much about what those codes are used for.

While it’s true that we can use diagnosis and procedure codes to track the spread of disease or the effectiveness of a particular procedure, their main use in the United States is in the reimbursement process. In other words, codes help us bill accurately and efficiently.

Let’s take a closer look at why we bill.

WHY WE BILLGoing to the doctor may seem like a one-to-one interaction, but in reality it’s part of a large, complex system of information and payment. While the insured patient may only have direct interaction with one person or healthcare provider, that check-up is actually part of a three-party system.

The first party is the patient. The second party is the healthcare provider. The term ‘provider’ includes hospital, physicians, physical therapists, emergency rooms, outpatient facilities, and any other place where medical services are performed. The third and final party is the insurance company, or payer.

It’s the medical biller’s job to negotiate and arrange for payment between these three parties. Specifically, the biller ensures that the healthcare provider is compensated for their services by billing both patients and payers. We bill because healthcare providers need to be compensated for the services they perform.

In order to do this, the biller collects all of the information (found in a “superbill”) about the patient and the patient’s procedure, and compiles that into a bill for the insurance company. This bill is called a claim, and it contains a patient’s demographic information, medical history, and insurance coverage, in addition to a report on what procedures were performed and why. Read more @ https://tinyurl.com/2p99buxw

09 Sep 2021

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MEDICAL BILLING PROBLEMS PLAGUE CONSUMERS!

Not only do health care costs pose a challenge to many consumers, but billing issues often create a financial headache, too, text a new survey shows.

Cedar, a company that provides a platform for paying health care expenses, interviewed 1,607 consumers of health care services to gauge how painful the medical bill payment process has been for some of them. They learned that billing challenges often have far-reaching implications.

About a third of respondents believe health care providers can stand to improve the billing and payment process. For example, one of the biggest challenges consumers face is trying to learn what they will be expected to pay ahead of time. Approximately 60% of respondents said they’ve tried to find out what their out-of-pocket costs would be before receiving care. However, 51% of respondents said they either couldn’t get that information easily or the information they received was not accurate.

Another area that causes frustration among many health care consumers is the lack of digital billing options, such as online bill pay and email bill delivery. In fact, approximately 20% of respondents have provided a negative review of a health care provider because they had a bad digital experience. Read more @ https://tinyurl.com/49tpnh2x

01 Feb 2020

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COMING SOON!

Drop us a line @ quermed@yahoo.com, what is your current concern and what would you like to know more about medical billing and coding?

Any thoughts? Try Us, we would be delighted to hear from you.