Over Latest Articles

Are you receiving low reimbursements?

Our most recent posts

Ancillary Services 101

Ancillary services are additional services, which are important to run an organization (not to be confused with ancillary services –

Read More »

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.

Read More »

What Behavioral Health Providers Need to Know about Value-Based Reimbursements

Value-Based Reimbursements change the game by offering outcome-based incentives to In-Network providers. Learn more about this important trend.Value-Based Reimbursements give In-Network providers an incentive to remain in a payer’s network, while tying a portion of their payments to patient outcomes. In doing so, the Value-Based system could help bring the cost of healthcare under control.And that’s not the only reason providers should embrace outcomes-based reimbursements. As of 2018 The Joint Commission will require outcomes-based data as a conditioned for accreditation. Other accreditation bodies are sure to follow suit.In this report, we look at how Value-Based Reimbursements, AKA “outcome-based reimbursements,” work and how providers can adapt to get out in front of this massive industry change.Insurer reimbursements are changing once again. This time, payments are being tied to outcomes. We see this as not a “trend” but a long-term solution to the issues that have long plagued payer-provider relations, the biggest being the disparity between In-Network and Out-of-Network payments.Traditionally, In-Network providers received a reduced rate for services, with the trade-off being that insurers funneled more patients to their practices. Out-of-Network providers, however, could charge whatever they deemed appropriate. This meant a huge gap between what In-Network and Out-of-Network providers were being paid for the same service, and led to In-Network providers crying foul.In theory, Value-Based Reimbursements change the game by offering outcome-based incentives to In-Network providers.In this report, we look at how Value-Based Reimbursements, AKA “outcome based reimbursements,” work and how providers can adapt to get out in front of this massive industry change.

Read More »