Articles By mgsionline

Published 10 Years Ago
Physician Quality Reporting System (PQRS)
In the history of the US Healthcare domain, several physician payment models, including fee-for-service, episode-based payment, and patient-centered medical home were introduced. However, most of these models failed to address the efficiency or measure of

Published 10 Years Ago
Outpatient vs. Inpatient Billing & Coding ? A Brief Discussion
The entire process involving medical billing and coding functions is quite tricky. Therefore, it is highly important that billing specialists ‘dot the i’s and cross the t’s’ of their claims before submitting them to the Payers. In

Published 10 Years Ago
Hospital Affiliated Specialties
Medical billing and collections for Hospital affiliated specialties is a major challenge that most Healthcare Facilities and Medical groups confront in their day-to-day operations. Even as they try to tackle this problem confidently, several complications

Published 10 Years Ago
Pay for Performance ? What Providers must know!
Gone are the times when Healthcare Providers got reimbursed for each and every service they rendered to their patients irrespective of the outcome. In the present era, quality is valued more than the quantity of services provided. It is better exhibited

Published 10 Years Ago
RAC Audits - Impact on Physicians
The RAC audit program has been around for 8 years now, having started in 2005 as a ‘demonstration project’.   While it was only the Hospitals – Part A claims - that were targeted due to the higher $ value for inpatient

Published 10 Years Ago
Bringing Down Old AR ? Billing Company vs. Collection Agency
The ups and downs of a Healthcare Facility’s revenue cycle are determined by the payment posting, which needs frequent reviews. If there are discrepancies in cash posting, then Providers are at a high risk of facing medical AR inflation. Regular

Published 10 Years Ago
Charge Master Review
Charge capture is considered one of the trickiest jobs in the medical billing and coding process flow next only to Coding.  Also, Coding and Charges go hand-in-hand to ensure successful payment of claims. It is for this reason that most healthcare

Published 10 Years Ago
Importance Of Chart Audits
One of the major factors that keep both healthcare and medical claims billing operations running smooth and uninterrupted is chart audits. Many Healthcare Providers and Facilities think that auditing medical charts wastes their effort, money and time.

Published 11 Years Ago
Fee-for Service Vs Value Based Payment
The transition from fee-for service to value based payment is presently a promising change in the healthcare domain. The main idea behind this transition is to deliver quality healthcare services to all US citizens at a lower cost. Before delving into

Published 11 Years Ago
Insurance Prior-Authorizations
Several factors influence insurance payments, of which prior-authorization seems to be one important factor that is often overlooked by Providers. What is Insurance Prior-Authorization? It is the process of obtaining an approval to cover specialty

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