With nearly 30 million residents, Texas maintains the second largest state population in the country. This burgeoning community includes diverse urban metropolises like Dallas, Houston, San Antonio and Austin as well as remote rural towns and border communities. The variability in patient demographics and healthcare access models across Texas locations generates pronounced impacts on medical […]
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With over 21 million residents, Florida maintains one of the largest and most demographically diverse state populations across the country. This presents unique dynamics around healthcare delivery and insurance for which medical billing service providers must adapt. From an aging population to an influx of northern transplants, to the millions relying on government insurance plans […]
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As US healthcare costs continue rising steeply – now over $4 trillion representing nearly 20% of GDP – both federal and state policymakers urgently seek ways to contain runaway expenditure growth. This drive manifests through expansion of programs like Medicare Advantage and Medicaid managed care coupled with accelerating passage of game-changing legislation like No Surprises […]
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At Medwave, we are dedicated to providing valuable insights and guidance on detecting and preventing healthcare fraud and abuse. We will equip you with the knowledge and tools necessary to safeguard your organization and patients from these malicious activities. By implementing the strategies outlined below, you can enhance the integrity of your healthcare services and […]
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Proper Verification and Accreditation in Medical Credentialing The process of medical credentialing is crucial in ensuring the quality and safety of healthcare services. It involves verifying the credentials and qualifications of healthcare providers and evaluating their competency to provide medical services. We examine the importance of proper medical credentialing and how it benefits both healthcare […]
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Medicare and Medicaid Fraud is a Massive Healthcare Industry Problem Medicare and Medicaid Fraud Vulnerability The Medicare and Medicaid programs provide crucial support to millions of Americans, offering access to healthcare services for those who may not otherwise be able to afford it. Unfortunately, these programs are also vulnerable to fraud, with criminals exploiting the […]
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Let’s begin with this set-up: Let’s say you’re hunting for a new job and receive a call from a would-be employer informing you that the job is yours. Of course, you’re thrilled by the news and inquire about your starting salary. Your new employer replies that you need to wait for your first paycheck to […]
Credentialing, healthcare credentialing, medicaid, medicare, private insurers, Provider Credentialing, provider networks, reimbursement rates
Home Health Services + Medicare What does Medicare Cover for Home Healthcare? If you’re looking for an answer to the question, “What does Medicare cover for home healthcare?”, you’ve probably typed it into a search engine and immediately closed the tab. The amount of information and the level of detail can quickly become confusing and […]
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The healthcare industry is changing rapidly, creating a host of challenges for healthcare providers. Cutbacks in reimbursements, bad debt and regulatory reforms all affect a provider’s revenue. Moreover, the failure to recognize claim submission mistakes heightens the risk of inadequate reimbursement and even nonpayment. While concentrating on ever-pressing needs, it’s difficult for providers to spot […]
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The Reasons Why a Medical Billing Assessment is Needed Medical Billing Assessments Running a healthcare practice means keeping a tight ship for the sake of your patients and your reputation, as well as your financial well-being. But, let’s face it, practices are only as successful as their medical billing performance. If you have a prosperous […]
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Understanding Medical Billing Myths Dr. John Smith owns a small practice in Pittsburgh’s South Hills. He’s in the midst of a conversation with one of his nurses. Nurse: “Doctor, do you think we should be posting signs concerning the payment of co-pays once the patient is finished with their appointment?” Doctor: “I agree to a […]
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Medicare, Medicaid Fraud Examples and Steps to Ensure You Don’t Commit It A medical doctor invoiced his patient’s Medicare insurance for both the services he actually delivered and for services that were not delivered. He fabricated his patient’s medical records to indicate office visits and treatments that never took place. A gerontologist obtained the outcomes […]
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Billing & Payment Processing for Medical Marijuana Cannabis A Proven Commodity Marijuana Cannabis is projected to be one of the fastest-growing industries over the next decade. Worldwide cannabis sales more than tripled, from $3.4 billion to $10.9 billion between 2014 and 2018, and Wall Street has forecast that sales will grow $30 billion by 2025. […]
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Medical Billing Techniques that Can Be Installed to Help Your Medical Practice Health care providers should periodically review their financials and revenue cycle, so that they can take corrective measures at the earliest if required. A great deal of medical offices / health care providers find that medical billing is one area which could be […]
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