April 30, 2013

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Patient Balances:  Are Carriers Calculating the Patient Payment Correctly?

Patient payments are on the rise.

You know it and statistics support it.  According to AthenaHealth PayerView 2012, the weighted Provider Collection Burden increased by 7 percent from 2010 - 2011 from 16.7 percent to 17.8 percent.  Where is it headed in 2013?

Higher, of course!

Because the patient collection burden is frequently difficult to calculate, patients invariably question the balance. Further, some patient balances may not seem consistent with the information obtained during the verification and/or eligibility check. It is important to have a request letter seeking clarification from the carrier regarding the patient deductible/co-pay calculations. Read the rest of this article for just such a letter. . . .

Continue reading this article at AppealLettersOnline.com

AppealLettersOnline.com Featured Letters

AppealLettersOnline.com has specialty-specific letters for the following areas of Specialty Care:

Anesthesiology, Cardiology, Chiropractic, Dermatology, Endocrinology, Gastroenterology, Mental Nervous/Substance Abuse, Neurology, Ob-gyn, Oncology, Orthopedics, Pediatrics, Reproductive Medicine, Telemedicine.

Be sure and review the following new letters under the Specialty Care Topic so that you can appeal denials by demanding review by a highly qualified reviewer using specialty-specific clinical guidelines.

  • Request for Specialty Clinical Criteria

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  • Request for Specialty Coding Criteria

Access the appeal letters at AppealLettersOnline.com


Last Chance to Register for Oklahoma ICD-10 Seminars
3 Hour Workshop on a Simple Step-by-Step ICD-10 Transition Only $49*

Learn how and why to engage doctors now on the benefits of ICD-10.

Learn the office processes that must change or be addressed and simple solutions for ICD-10 compliance.

Learn what to ask payers and vendors and what exactly you need to renegotiation with your payers to protect reimbursement under ICD-10.

Understand how to start now in order to reduce your overall ICD-10 transition costs.

Get the simplest solutions for the upcoming challenge and go home an ICD-10 champion for your organization.

Tammy Tipton, President of Appeal Solutions, will be in two Oklahoma cities presenting ICD-10 Now!  How and Why.  This $59 ICD-10 Transition seminar covers everything necessary for a practice's education and organizational phase of ICD-10 transition, pre-implementation impact areas and post-implementation risk mitigation.  The Tulsa, OK presentation is set for May 7 and the Norman, OK presentation will be May 10.

Tammy Tipton, President of Appeal Solutions, will be presenting the Oklahoma seminars as part of the ICD-10 education effort involving a number of upcoming live seminars and webinars developed by Complete Practice Resources. Tipton is part of a team of ICD-10 transition experts which include practice management, billing, motivational and adult education experts who have collaborated with Complete Practice Resources in order to develop a best practices approach to ICD-10 transition.
"This is an outstanding value for any organization which needs to get started and wants to proceed with an organized, step-by-step implementation process," said Tipton. "I am very excited to present CPR's excellent transition material which I believe will allow practices to capitalize and thrive in the upcoming ICD-10 environment."

See a complete list of upcoming seminar cities and dates at http://www.cpticdpros.com/icd10-seminars.html.  *Use the Appeal Solutions coupon code, TT001, and receive an additional $10 discount from the listed price.  **Please note, the seminar pricing is currently priced at a discounted introductory price and will likely increase in the near future.

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