Providers saving with credentialing datasource
More than 400,000 providers are now using a data collection service to streamline the delivery of credential information to healthcare organizations. CAQH’s Universal Credentialing Datasource allows physicians to enter all credentialing information, including their new National Provider Identifier, into a universal database that organizations and payers can access in real time. Physician and payer groups including the American Medical Association and America’s Health Insurance Plans are supporting the service.
medical group’s finances managed with web tool
Spokane, Wash.-based Rockwood Clinic, a 163-physician multi-specialty practice, has begun using a Web-based tool to assist with financial procedures such as payer contract management. Rockwood will use Medical Present Value Inc.’s Phynance application and consulting services to audit reimbursements, value medical claims and identify errors in coding, posting and registration.
Texas physicians call for cancelling rating system
The Texas Medical Association’s claim that a new Web-based physician rating system is an “attempt to put profit before patient care” has prompted Blue Cross and Blue Shield Texas to delay the system’s launch. TMA claimed that the ratings system, which would have been available to 3.3 million members of a BCBSTX plan, relied too heavily on patient bills and used faulty data. TMA President Ladon Homer, MD, said, “Our state legislature needs to pass reforms to stop health insurance abuse and gimmicks that are sacrificing our state’s public health for corporate insurance company profits.”
Automated coding updates ensure reimbursements
Durham, N.C.-based Triangle Orthopaedic Associates, a surgical group made up of 60 providers, has begun using a new revenue cycle management system that offers automated updates of payers’ coding rules and E&M service coding reviews to ensure proper documentation and reimbursement for procedures. The system, provided by athenahealth, also allows practices to share billing information and patients’ financial data throughout physician networks.