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[ANSWERED] What is a Payer Agreement?

Etactics

On average, a healthcare provider has between 16 and 20 payer contracts. There’s no right answer, but understanding what a payer agreement is will show the significance of that average number. A payer commonly looks like insurance companies, government programs, and employers. There all different types of payers.

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Thinking Ahead on the AHEAD Model: Primary Care AHEAD

NASHP

This blog post summarizes both the Primary Care AHEAD requirements identified by CMS and additional strategic considerations for states. See the first blog post in the series covering governance and the second blog post describing hospital global budgets. A core aspect is a focus on alignment between payers.

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[ANSWERED] What is Remittance Advice?

Etactics

Receiving payment is important, no matter what industry you’re in. In this blog, we’re taking it one step further by referring to remittance advice, or RA, specifically in the healthcare industry. After the appointment, the healthcare provider will send an invoice out to the payer. Remittance literally means to pay back.

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Thinking Ahead on the AHEAD Model: Hospital Global Budgets 

NASHP

This blog post summarizes both the global budget requirements identified by CMS and additional strategic considerations for states thinking about whether they will pursue the AHEAD Model, to ensure they are well-positioned for application, negotiation, pre-implementation, and implementation.

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Thinking Ahead on the AHEAD Model: Governance

NASHP

This blog post summarizes both the governance requirements identified by CMS and additional strategic considerations for states thinking about whether they will pursue the AHEAD Model, as well as states that are applying to ensure they are well-positioned for application, negotiation, pre-implementation, and implementation.

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How to Detect Frauds in Medical Billing Effectively?

p3care

In this blog, we will get to know the techniques for successfully identifying fraud in medical billing services. It can happen via a variety of tactics, such as: Upcoding is when a provider bills for a more expensive service than what was given. We can examine financial agreements and contracts with other providers.

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Denial Code CO 45: What it is and How to Get Help

Etactics

Knowing the different denial codes and what they stand for is just part of the equation. Let’s take a closer look at CO-45 including what it is, how to correct it and how to collect on it. What is a denial code? What does “CO” mean? What is denial code CO 45? What is a denial code? What is a denial code?