MEDICAL BILLING

The Ins and Outs of Your Clearinghouse

Clearinghouse represents the first step on a reimbursement claim’s journey toward money in a clinician’s pocket, but a lot can happen once it’s transmitted from the practitioner’s office. In this revealing article, Nitin Chhoda provides an inside look at factors that... read more

Medicare: The Government – Your Biggest Payer, Part 1

Clinicians will contract with many commercial insurance providers during their careers, but the heavy hitters of reimbursements are government-backed insurance plans. In this informative two-part series, Nitin Chhoda examines programs operated by the federal... read more

Claim Appeals 101

Reimbursement claims can be denied at any time and for any number of reasons. Most problems can be remedied easily, but when talking fails to facilitate a desirable outcome it may be necessary to file an appeal. In this revealing article, Nitin Chhoda addresses the... read more

Insurance: The Rules, Regs and Who Makes the Decisions

The rules governing healthcare insurance procedures are as varied as the companies that offer policies. Payers may choose to follow the same regulations as government backed insurance plans, while others have developed their own unique set of parameters. It’s... read more

Medical Payer : Who Is It and Who Has the Money? Part 2

Most patients have a commercial healthcare insurance plan that pays a portion of the cost should they become ill or require medical attention. Commercial plans account for the bulk of a practitioner’s reimbursements, but an extensive array of government operated... read more

Why Medical Necessity is Necessary

Medical professionals must prove that that a particular service or treatment was necessary before a patient’s healthcare insurance provider will pay for it. Medical necessity trumps other criteria in the adjudication process and Nitin Chhoda provides new insights into... read more

The Life of a Claim: How You Get Paid

The clock starts ticking on the life of an insurance claim the moment a patient makes an appointment and doesn’t end until the practitioner is paid. To better understand the life cycle of an insurance claim, Nitin Chhoda offers a first-hand look at the process. First... read more

Payer : Who Is It and Who Has the Money? Part 1

Medical professionals collect reimbursement payments from a variety of sources. Known as payers, they encompass commercial insurance companies, third-party administrators and government-funded programs. In part 1 of this revealing article, Nitin Chhoda identifies the... read more