coding – MyQuerymed

09 Feb 2022

Business, News myquery 0 comment

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.

22 Jan 2022

Business myquery 0 comment

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

Business myquery 0 comment

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