Blogs

Let's begin by addressing the fundamental question: Why is healthcare provider credentialing so crucial? By knowing about the significance of healthcare provider credentialing, which is also referred ...

The Safety Assurance Factors for EHR Resilience Guides (SAFER Guides) were initially released in 2014 and updated in 2016. They were designed to help health systems conduct a proactive risk assessment...

Did you know that one of the largest risk factors for a data breach may come from inside your organization? It is estimated that 95% of security breaches are caused by human error. This blog discusses...

Performing a MIPS Security Risk Assessment (SRA) will help you to identify any potential areas where your organization’s protected health information (PHI) could be at risk. An SRA can reveal the we...

Since 2017, CMS has been making incremental changes to the Merit-Based Incentive Program (MIPS). In 2023, a new reporting path, the MIPS Value Pathway (MVP), was launched. The intention behind the new...

In the intricate landscape of healthcare, maintaining regulatory compliance is not only crucial but also a challenging task. As healthcare providers strive to navigate the ever-changing payer networks...

By examining every stage of the revenue cycle process, from patient registration all the way to payer reimbursement and financial management, we aim to empower you with the knowledge and strategies ne...

In today's rapidly evolving healthcare landscape, accurate and timely Medicare provider credentialing has become paramount. The traditional manual approach to credentialing, with its extensive paperwo...

As a Nurse Practitioner (NP), starting a private practice can be a great opportunity to have greater control over patient care, working independently, and increasing earning potential. However, the re...

As a Nurse Practitioner (NP), starting a private practice can be a great opportunity to have greater control over patient care, working independently, and increasing earning potential. However, the re...

Healthcare organizations often find it challenging to negotiate contracts with fee-for-service payers, however, a well-crafted plan can lead to successful negotiations....

MIPS stands for Merit-based Incentive Payment System, a compliance program developed by the Centers for Medicare & Medicaid Services (CMS). The MIPS program incentivizes and rewards eligible clinician...

Have you ever wondered if dental credentialing is worth the investment? Sure, it might seem like a hassle to go through the credentialing process and deal with insurance companies, but most say it is ...

Denied claim appeals refer to the process of challenging a payers decision to deny reimbursement for a healthcare service or treatment. When the insurance denies a claim, an appeal can be filed to cha...

Revenue Cycle Management (RCM) is an essential component of the medical practice or healthcare organization, and it encompasses the management of financial transactions between patients, providers, an...

Medical credentialing services can be particularly important for healthcare providers who are seeking to join a new healthcare network or insurance plan, as well as for healthcare facilities and organ...

CMS has released a notice stating they will be conducting MIPS data validation and audits for the performance years 2019, 2020, and 2021. This process is set to begin in January 2023. Regulations req...

At the end of July, CMS released its 2023 Proposed Rule for MIPS Reporting. There were some notable changes proposed, including additional MVP options and measure changes for the Promoting Interoperab...

Starting a new medical practice can be a very intimidating process, whether you are fresh out of medical school or transitioning from being a provider at a larger health system to your own private pra...

Durable Medical Equipment (DME) is medical equipment that is ordered by healthcare providers for patients. This equipment can include CPAP machines, walkers, wheelchairs, oxygen equipment, canes, crut...

Healthcare spending in the United States was19.7% of the total GDP in 2020 and it has beenprojected by CMS to continue increasing. While the United States is a leader in some preventative care measure...

In an effort to improve quality and decrease cost in American healthcare, CMS has introduced a new program to improve upon traditional MIPS. MIPS Value Pathways (MVPs) are a subset of the measures and...

Becoming a credentialed provider is a lengthy and complicated process and the timeline to get credentialed can differ from payer to payer.When sending applications to becomean in-network provider with...

On December 13, 2016, the 21st Century Cures Act was adopted into law. It includes a wide range of improvements to the health care system. In May of 2020, the Office of the National Coordinator for ...

The COVID-19 pandemic has placed a great amount of strain on the healthcare industry and as a result, providers have had to adapt in order to provide care to their patients and continue to maximize th...

Throughout the entire credentialing process, there are multiple situations that may occur and can affect the timeline of a provider’s credentialing. Some of these situations can be avoided or prepar...

Payer contract negotiation is a complex and often stressful process, but it is extremely necessary to ensure maximization of revenue for providers. Most healthcare practices leave the task of contract...

Since 2020 has ended and the new year has begun, it is important to stay abreast of the new requirements for MIPS in 2021. ...

Based on CMS guidelines, below are some of the important upcoming MIPS (Merit-based Incentive Payment System) dates and deadlines:...

Due to the urgency to expand the use of technology to help patients who need routine care, and to keep vulnerable patients in their homes while maintaining access to the care they need, CMS broadened ...

The HHS Office for Civil Rights (OCR) has issued the HIPAA Notification of Enforcement Discretion during the COVID-19 emergency. This notice applies to all health care providers that are covered by HI...

Due to the urgency to expand the use of technology to help patients who need routine care, and to keep vulnerable patients or patients with mild symptoms in their homes while maintaining access to the...

The Centers for Medicare & Medicaid Services (CMS) is proactively taking steps to ensure that patients, healthcare facilities and clinical laboratories are prepared to respond to theCOVID-19, a diseas...

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is a federal law that establishes national standards to protect individuals' medical records and other personal health informati...

Becoming a credentialed provider is a lengthy and complicated process.The timeline to become credentialed can differ from payer topayer. ...

The Centers for Medicare and Medicaid Services (CMS) released its Final Rule for the 2020 Merit-based Incentive Payment System (MIPS) program. The Final Rule continues to gradually increase the report...

CMS just posted the proposed rule for MIPS 2020 which comes with a lot of continuous changes! While you are still trying to understand the new rules that came with this year’s reporting, we are cons...

Approximately 38.4 percent of men and women will be diagnosed with cancer at some point in their life, while 7.6 million people die from the disease. With cancer becoming more common, many patients ar...

1. What are the categories for MIPS 2019 reporting and how are they weighted? Quality – 45 points Weighted from 50% to 45% Many benchmarks changed Multiple measures removed and many common measures ...