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Archive for July, 2011

Major Savings from Medicare Drug Plan

Tuesday, July 26th, 2011

According to a new study, Medicare’s 5-year-old prescription drug plan is saving the federal program approximately $12 billion a year by keeping seniors out of nursing homes and hospitals. The savings offset only a fraction of the $55 billion the government spends on the drug plan, known as Medicare Part D, per year. The authors of the study claim that it means seniors are enjoying a better quality of life and staying healthier.

Appearing in the Journal of the American Medical Association, the Harvard analysis found that Medicare saved an average of around $1,200 per year for each senior citizen who had insufficient drug coverage prior to Medicare Part D. Lead author Dr. Michael McWilliams of Harvard Medical School said that with subsidized drug coverage, seniors are able to afford drugs that lower cholesterol and blood pressure and control diabetes, thus preventing trips to the emergency room—and medical bad debt collection for seniors unable to afford medication and emergency room bilss.

Medicare Part D is voluntary and there were 23 million Part D beneficiaries last year. Enrollees pay premiums covering approximately 25 percent of the cost.

The Medicare drug benefit began in January 2006. Prior to that date, around 2,500 of the seniors in the study reported having generous drug coverage—often purchased as supplemental insurance—while around 3,500 reported having limited or no drug coverage.

Check back for more news on billing for medical services and more.

How You Can Stop Medicare Fraud

Wednesday, July 20th, 2011

Last month, the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) paired together for the sixth Health Care Fraud Prevention Summit, held in the City of Brotherly Love (Philadelphia).  Since the start of the Health Care Fraud Prevention and Enforcement Action Team (HEAT) task force back in 2009, more than 670 defendants have been charged for attempting to defraud Medicare of over $1.3 billion in taxpayer dollars!

Fraudulent Medicare claims are now being predicted and identified using the same technology that your bank uses to protect you from credit card fraud. This helps Medicare stay one step ahead of criminals.

As billing specialists, we have some tips for stopping Medicare fraud in your own home:

  • Be wary of anyone who offers you free medical equipment or services and subsequently requests your Medicare number. They do not need your number!
  • It is illegal to let anyone borrow or pay to use your Medicare ID card or identity. So don’t do it!
  • Treat your Medicare and Social Security cards like they are your credits cards and keep them safely guarded.

Stay tuned for more news on credentialing medical!

New Rules

Monday, July 18th, 2011

Today (July 18), the Department of Health and Human Services issued rules to cut down on the amount of paperwork that buries doctors, nurses and other caregivers. So what does this medical bill management news mean for you? Well, your doctor spends an average of 12 cents of every dollar to hire staff to fill out insurance forms, so this means doctors will get paid quicker for treating you.

According to some predictions, these changes will save the U.S. healthcare system $12 billion over the next 10 years. It will also free up caregivers to spend more time with patients, which is what everyone wants, right?

This will mean fewer phone calls negotiating physicians and health plans, lower paperwork and postage costs, and fewer denied claims—and it means physicians can spent more time and money administering quality care and less time dealing with billing and collections and more red tape.

These rules were called for by the Affordable Care Act and means that doctors and other health care professionals will be able to use one simple form to ask your insurance company if you are eligible for benefits. Under these rules, a second form will be used for doctors’ offices to check the status of insurance claims they have filed. Insurers have agreed to forgo multiple systems and accept these forms.

Major Savings from the Affordable Care Act

Tuesday, July 12th, 2011

Nearly half a million Americans enrolled in Medicare’s prescription drug benefit have received a 50 percent discount on their out-of-pocket costs during the first five months of this year, due to the Affordable Care Act. Due to Medicare improvements in the Affordable Care Act, beneficiaries  now receive a 50 percent discount on covered brand-name drugs in the Part D coverage gap (nicknamed “donut hole”). This has saved them more than $260 million this year, and 2011 is only half over!

The number of beneficiaries receiving the discount increased by a whopping 76 percent in May alone, and the total savings these beneficiaries received grew more than 56 percent in one month. That means there was a total average savings of $545 per beneficiary!

The majority of these discounts are helping Americans with serious medical conditions cope with medical bill management. More than $36 million thus far are for cancer drugs, $21 million for controlling high blood pressure and cholesterol and around $20 million for drugs for diabetic patients.

Also thanks to the new law, as of June 10, around 5.5 million people with Medicare have accessed one or more preventative measures. Stay tuned for more news from Las Vegas Integrated Medical Management!

All About Integrated Medical

Friday, July 8th, 2011

We have been specializing in billing and collections in Las Vegas and Henderson for more than 16 years, using cutting edge technology to make sure claims are submitted very quickly. According to the Medical Group Management Association (MGMA), the average percent of accounts receivable over 90 is 21.56%–but ours is less than 8%, and we have an average days to payment of 21.

Providers choose us for the following reasons:

  • Automated Claims Follow-up Processing
  • On-Line Patient Payment 24/7
  • Real-Time Access to Account Data 24/7
  • Reimbursement Tracking
  • Recurring Internal Audits
  • Automated Accounts Receivable Management
  • Electric Document Storage and Retrieval
  • Fast Turnaround Time for Electronic Claims Submission
  • Staff Training
  • Automated Concurrency Tracking
  • Ad Hoc Reporting Capability
  • HIPAA Complaint
  • Reduced Employee Headaches
  • Custom Reports at No Cost

Contact us for a free audit to see how we can help you with medical revenue management!