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A Wakefield company

6 Ways to Improve Out-of-Network Reimbursements, Despite Surprise Billing Changes

6 ways to improve your out-of-network reimbursements, despite surprise billing changes Payer Tactics To Decrease Your Revenue Let’s first talk about the tactics payors use to decrease your revenue. The vendors who work for the insurance companies to reduce out-of-network (OON) payments, such as Viant and Multiplan, each receive over 10 million out-of-network bills each… Continue reading 6 Ways to Improve Out-of-Network Reimbursements, Despite Surprise Billing Changes

CRXIS – What Does It Mean?

CRXIS – Our  Business Intelligence Engine One of the biggest reasons for our success is what we call our CRXIS business intelligence engine. CRXIS serves as one of the largest out-of-network (OON) databases in the industry. No other revenue cycle company has as much information on out-of-network as we do. CRXIS stands for Collect Rx… Continue reading CRXIS – What Does It Mean?

Industry Factors Affecting Out-of-Network Reimbursements

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Industry factors affecting your out-of-network reimbursements It’s no secret that out-of-network has gotten more difficult over the past couple years.  Insurance companies are inducing more roadblocks causing difficulty for providers to get their due payments. The same workflow you’ve used to negotiate out-of-network bills is resulting in reduced results. Which are based on restrictions imposed… Continue reading Industry Factors Affecting Out-of-Network Reimbursements

Revenue Cycle Management: Issues & Solutions as an Out-of-Network Provider

Healthcare.

Top 5 Issues & Solutions to Success in Revenue Cycle Management for Out-of-Network Providers Revenue Cycle Management is not easy.  It requires a vast amount of knowledge, attention to detail, and expertise in a variety of skillsets. Providers can have issues like poor cash flow, aged receivables, and increased denials. This is due to the… Continue reading Revenue Cycle Management: Issues & Solutions as an Out-of-Network Provider

Why you’re not “doing fine” with your out-of-network reimbursements

Behavior Modification at Work Vector Illustration. Emotional Stress and Physical Exertion at Work. Man Sweats Sitting at Table Office. Managing Stress Management Individually Cartoon.

Why you’re not “doing fine” with your out-of-network reimbursements Don’t believe us? Keep reading… Some providers believe they don’t need to think about what’s happening with their out-of-network (OON) business because they’ve got it under control through one or more of the various tactics. Unfortunately, what we see all too often is that many times… Continue reading Why you’re not “doing fine” with your out-of-network reimbursements

5 Out-of-Network Myths Debunked!

5 Out-of-Network Myths Debunked Have you heard any of these? Read on! Here at Collect Rx we are continually amazed at how often people either have it half right or not right at all when it comes to the out-of-network (OON) industry realities. What surprises us even more is that providers don’t take advantage of… Continue reading 5 Out-of-Network Myths Debunked!

Surprise Billing: More Details on Dispute Resolution

Surprise Billing: Issues with Dispute Resolution? If an insurance company is not complying with the Dispute Resolution Process, read on! If we know one thing, it’s that insurance companies will do anything to pay you as little as possible. Now, with the new surprise billing changes, particularly within the Dispute Resolution process, there’s yet another… Continue reading Surprise Billing: More Details on Dispute Resolution

Surprise Billing: Helpful Information

Surprise Billing: Important Takeaways Don’t be surprised by the Surprise Billing changes! By now, we know the goal of the No Surprises Act is to protect patients from receiving bills from out-of-network providers that they did not willingly choose. But what does that mean for out-of-network providers? Who does it affect? The No Surprises Act… Continue reading Surprise Billing: Helpful Information

Why Patient Authorization Forms Are Necessary

Patient Authorization Forms are Necessary Patient authorization forms – or shall we say, payor specific authorization forms… are time consuming and at times overwhelming. BUT, it IS worth the inconvenience to maximize the reimbursement on your claims in a timely manner!  As we go through more and more challenges in the health insurance industry, we… Continue reading Why Patient Authorization Forms Are Necessary

Payer Mix

4 Key Components in Understanding Your Payer Mix Payer Mix, or more simply put, the type of insurances your patients have, has a direct impact on your practices bottom line. However, it is also one of the items many ASC’s struggles to optimize.   Regardless of a practice’s network status, payer mix can fluctuate and… Continue reading Payer Mix