Evolent’s Post

"Thad, why can't we just go to any private specialist for our treatments?" This is a very common question I get when I'm explaining to my clients on the difference between panel and non-panel doctors. Simply put, the panel of doctors is meant to ensure a more consistent and transparent calculation of your treatment costs. Insurers have a well defined list of medical procedures that are covered, and thus consulting a panel doctor can give you greater assurance of your bill being covered. But are there situations in which we need to consult a non-panel doctor? 🤔 Drop me a note and I can explain to you in greater detail. https://lnkd.in/gdYvDqTT

📄🔎 A recent analysis shows a surge in in-network claims after surprise billing protections took effect. Read more about the findings from FAIR Health, Inc. in this Axios article. 📊 #HealthcareInsights #NoSurprisesAct #SurpriseBilling

Don't let errors hold you back! Swipe through to learn the 6 most common mistakes in cardiology billing and how to avoid them. From improper documentation to using vague terms, these issues can significantly impact your bottom line. Visit our website https://lnkd.in/gnSsHxwT to learn more about our medical billing services! . . . #cardiologybilling #medicalbilling #healthcare #doctor #revenue #cyclemanagement #medicalpractice #insurance #coding #healthcaretips #patients #efficiency #profitability #avoiderrors #growth #talismansolutions #medicalprofessionals #healthcarebusiness #medicaleconomics #healthcaremarketing #medicalcoder #physicianpractice #medicaloffice #medicaleconomics #healthcarecommunication #healthcareleaders

Efficient Billing Solutions for Large and Complex Cardiology Practices The complexities of cardiology services, coupled with ever-evolving insurance regulations and the demands of multiple payers, can overwhelm even the most seasoned practice. In this article, we explored the challenges faced and the efficient billing solutions for large and complex cardiology practices. Read More: https://bit.ly/3ZLnyMM #RCM #Reimbursement #Claims #Denials #ClaimDenials #ChargeEntry #PaymentPosting #ClaimSubmission #AccountsReceivable #DenialManagement #MedicalBilling #MedicalCoding #RCMServices #RCMProcess #MedicalBillingServices #MedicalCodingServices #MedicalBillingCompany #Healthcare #RevenueCycleManagement #RevenueCycle #CredentialingServices #MedicalBillingSolutions #MedicalBillingandCoding #MedicalBillersandCoders #BillingSolutions #CardiologyBilling #CardiologyBillingServices

Decoding the Art of Choosing a Primary Care Physician: Whether it's a concierge practice or non-membership model, delve into insurance complexities, online reviews, interviews, and the underrated influence of referral networks. Navigate with Practical Steps in My Latest Article. #healthcarechoices #PrimaryCareInsights

A recent study by researchers at Johns Hopkins University found a significant pricing disparity for imaging services between commercially-insured patients and those covered by Medicare Advantage at the same hospital. The median commercial-to-Medicare Advantage price ratio was 2.4 for imaging. The study suggests that different market incentives for insurers contribute to these higher costs for commercial plans, highlighting a need for policy efforts to address these pricing imbalances. https://lnkd.in/gCXTZvpF

We are often engaged in conversations about the usability of electronic medical records - how often are they actually providing the information required to perform a mortality or morbidity assessment. MIB's Carolyn McAvinn, FLMI, AALU, PMC-IV conducted a study of MIB's electronic health records to assess this - and if you are not currently using the MIB EHR to streamline your underwriting, the results of her analysis may give you FOMO! https://lnkd.in/eTzucXyf

This recent case study from AppriseMD highlights the benefits that physician advisors with hospital-based clinical experience combined with utilization management experience can bring to hospitals when it comes to reversing short stay denials. https://lnkd.in/eJ-PFTic

Radiologists play a crucial role in the larger battle against payers’ unfair practices. The American College of Radiology is calling on providers to report incidents where insurance companies misuse the #NoSurprisesAct, threatening exclusion from their networks unless lower reimbursements are accepted. "The problem with #MedicalBilling law is really in many ways a Trojan horse. The law is being used by some #insurers to push through some policies that allow them to reduce #reimbursement to hospitals and physicians benefiting the insurance company, but at the expense of the hospitals, physicians and the patients they take care of. This is completely unrelated to the issue of #SurpriseMedicalBilling," explained Dr. Richard E. Heller, III, MD, MBA, FACR, RSNA Board member, associate CMO for health policy and communications, and national director of pediatric radiology at Radiology Partners. By documenting these cases, radiologists contribute to building a case against these payer practices, ultimately protecting providers and patients. Allia Group recognizes this unfair practice and invites radiologists to explore our unique litigation model, a powerful alternative to #IDR and traditional #litigation. Visit allia.group for more information, and watch the interview with Dr. Heller by visiting the link in the comments. #radiology

This recent case study from AppriseMD highlights the benefits that physician advisors with hospital-based clinical experience combined with utilization management experience can bring to hospitals when it comes to reversing short stay denials. https://lnkd.in/eav46t6s