Month: October 2023

Single Case Agreements 101

Single case agreements are contracts between an insurance company and an out-of-network health care provider for specific patients for billing in particular cases. They allow out-network patients to benefits. from in-network billing benefits. There are two ways for billing after the approval of SCA. First, the insurance company provides the allowed amount, finalized as per […]

Mental Health vs. Substance Abuse

There are all sorts of therapies and rehab programs to treat substance abuse these days. However, recent studies and observations indicate substance abuse not always being a standalone problem. This information also implies that, for decades, it’s not just substance abuse that has been a problem, but also the way patients undergo treatment.  Providing proper […]

Ancillary Services 101

Ancillary services are additional services, which are important to run an organization (not to be confused with ancillary services – electrical). They are set up to provide full service to the customers and also help increase revenues an organization’s revenue. In hospitals, ancillary services are the ones other than room, nursing, medical, and board services. […]

Utilization Review Technology Improves Outcomes for Behavior Healthcare Providers

If you’ve worked in the behavioral healthcare realm for more than a few months, you already know treatment services aren’t always utilized the way they should be. This is more often due to billing problems than treatment issues. Because of this, the utilization review process has disintegrated over time, and now providers need multiple full-time employees to deal with insurance companies, handle medical billing, process insurance claims, and pursue medical collections.

Current Trend in the Behavioral Healthcare Industry of Going In-Network

Currently, many behavioral healthcare providers are turning toward the option of going in-network rather than away from it. For those who don’t know, the term in- network refers to the option of connecting with certain health programs and/or insurance companies at a negotiated rate in order to provide care to individuals who are covered by […]

Changes in the Lab Industry Regarding Lowered Reimbursements and Current Challenges

Protecting Access to Medicare Act (PAMA) became a part of law on 1 st April 2014. The purpose of the act includes extending payments of Medicare physicians and other provisions. Instead of solving problems for healthcare facilities and clinical labs, these changes only complicated matters. PAMA introduced some vivid changes in the Medicare Clinical Laboratory […]