News and Articles

New AMA Health Insurer Report Card Finds Increasing Inaccuracy in Claims Payment

June 20, 2011—The average medical claims-processing error rate is up 2% from 2010—that's a nearlly 20% error rate among health insurers.
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IRS Delays Enforcement Of 3% Withhold Rule

May 31, 2011—Congress decides to push back Medicare from withholding IRS tax money for another year.
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First EHRs Certified for Meaningful Use

October 8, 2010—The Certification Commission for Health Information Technology (CCHIT) announced the first group of electronic health record (EHR) systems to be ONC-ATCB certified for 2011/2012. The certification means the EHRs are eligible for the Medicare or Medicaid reimbursement programs. The Dummond Group has also released its first group of ONC-ATCB certifed EHRs. A complete Certified HIT Product List (CHPL) is available is available at

CMS Announces “Meaningful Use” Rules

July 15, 2010Does that mean it’s time to buy an EHR? Maybe not. If you have been thinking about moving to an electronic health records (EHR) system, in hope of the federal government subsidizing the cost, you might be led to believe the time to act is now. After all, the promise of $44,000 per physician from the Medicare (or up to $63,750 under Medicaid) is pretty alluring. Getting that money, however, is not automatic, and not every EHR may qualify. In fact, right now as of today, no EHR is qualifies for the reimbursement. Not even one.
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Congress Passes Temporary Medicare Fix, Confusion Continues

June 25, 2010—Last night the House passed H.R 3962, which will fix the Sustainable Growth Rate (SGR) for the next 6 months. The bill is being sent to the President for his signature, which is expected. The bill will rescind the 21.3% reduction retroactively to June 1. Also, the Medicare Conversion Factor will be increased by 2.2%. That’s the good news.
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UBH & PacifiCare Mandate Change for Employee Assistance Programs (EAPs)

June 24, 2010Effective July 1st, all Employee Assistance Program (EAP) mental health claims must include a specific modifier to be paid. To meet that requirement, we need your help in identifying when a patient is covered by an EAP. Without the EAP information, we cannot bill the claim accurately, and United/PacifiCare will either process the claim as a standard insurance claim or deny it.
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Managing Patient Balances in Trying Times

Patients don't like to pay medical bills, and a growing number simply don't pay. The trouble is, as the economy puts the pinch on everyone, more out-of-pocket burden gets shifted to the patient in the form of larger patient deductibles, coinsurance, and copays. As patient responsibility grows, so will your patient accounts receivable.
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Reimbursement Is All About Follow-Up

So here’s how it works: You see a patient, your biller submits a claim, and you get paid. Right? The answer, of course, is “no.” The ugly truth is that many claims are never adjudicated.
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