Precertification, or insurance prior authorization, is the process of seeking approval from the patient’s health care plan before moving forward with the treatment. In the complex world of healthcare insurance, navigating the intricacies of prior authorization denials...
The changes taking place in the health industry have also affected dental care. Dental practices need to be alert to verifying dental insurance verification, benefits and predeterminations before...
Most healthcare plans ask for pre-authorization for certain services rendered at a healthcare facility. The list of services may vary according to the plan and insurance company. The aim of the...
There are certain services that require pre-certification, pre-notification or pre-authorization from the insurance company. You need to make sure whether a particular service requires...
Pre-authorization or written approval from the insurance company is required for certain medical procedures (for example, outpatient surgery, MRI, CT or PET scans, chemotherapy or radiotherapy)...
Cardiac transplantation or heart transplantation is recommended as a treatment for people having severe heart failure and severe symptoms despite providing maximum medical therapy. Heart transplants...
The United States Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) recently...
This February, the U.S. government proposed a 0.9 percent cut in payments to insurers for Medicare Advantage (MA) plans for the year 2016. The proposal came as part of a notice issued by a division...
The Patient Protection and Affordable Care Act (ACA) was implemented to enable easier and more effective healthcare access to millions of Americans. Presently, the health insurance marketplace is...
It's time to focus on your dermatology medical billing as new developments in the healthcare field implies a reduction in physician payment in 2015 and may be in the coming years. In October 2014,...
A new study from the "UCLA Center for Health Policy Research" reports that the expansion of Medicaid under the Affordable Care Act (ACA) may lead to considerable increase in the use of emergency...