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Summary of Services

The FIRM provides professional claims billing services for individual providers, clinics and facilities. We service all disciplines of practice, i.e., medical, dental, diagnostic testing, chiropractic, physical therapy, optometry/ophthalmology, mental health, chemical dependency, and durable medical equipment.

We offer specialty services such as consultation, collections and appeals, contracting and credentialing, verification and preauthorization and personal injury settlement negotiating. We offer form development and revision services, office reorganization and personnel training.

We have extensive experience in all areas of commercial insurance, Workers Compensation, personal injury, Third Party Administrators, Medicare, Medicaid, and other state and federally funded programs. We offer personalized services designed specifically to meet your needs.

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Emergency cash a must for ICD-10

ICD-10 is coming October 1st. Are you ready? Extra funds can go a long way to relieving anticipated headaches of code change Healthcare providers may face disruptions in their payments even if they are on target to operate using ICD-10 codes on Oct. 1, 2014. Since providers will, and indeed need, to be able to pay rent and staff salaries if the transition does not flow as smoothly as testing has indicated, experts advise having up to several months' cash reserves or access to cash through a loan or line of credit to avoid potential headaches. "Just figure that with the transition to ICD-10 there will be delays in reimbursement," said April Arzate, vice president of client services at MediGain, a Dallas-based revenue cycle and healthcare analytics company. Although there will be a great deal of testing and preparation done by the vendors of practice management and electronic health record (EHR) systems by clearinghouses and payers, "we really won't know the true effect until they turn it on," Arzate added. Mitigate revenue disruption The recommendation that Arzate pointed to is to reserve at least enough money to cover medical supplies, payroll, rent, everything required to keep the practice operational for three to six months — just in case any payers experience disruptions in cash flow that delay payments. That's especially difficult for small practices. "You may not have to have it on hand," Arzate explained, "but you need to have the resources available." It's better to talk with the bank now before the funds are needed, added Clint Hughes, MediGain vice president of marketing. "The bank will be more open now than if you come to them desperate because you're two months behind," he said. Arzate suggested that they establish [...]

How Doctors can really cut costs for medicare patients.

The best use of Medicare Oversight? Follow the Real Money Physicians are eyeing the wrong procedures in the quest to cut costs for Medicare patients. By Mark Pauly May 15, 2015 | 4:15 p.m. EDT Physicians have, of late, played an amazingly small role in guiding health policy. They had little to say or do with health insurance reform, which was the major focus of the Affordable Care Act. But to some extent, they have been trying to get on the right side of history by expressing concern about growing medical care spending and identifying services they control or sell that might be eliminated. The "Choosing Wisely" campaign, for example, has recruited physician specialty societies to compile lists of medical treatments that they were formerly choosing unwisely. No one could question efforts to deter care that is harmful or a waste of time. But if physicians expect to enlist consumers and insurers in this campaign, it would help if doctors were doing more than criticizing what other doctors do. It would help if their criticism was based on evidence of actual patterns of care observed in large data sets and if the reasons for such criticism could be well-identified. It would also help if changing the practices they criticize might lead to saving some serious money. The most recent example of physician efforts to document low-value care is a study reported last month in the New England Journal of Medicine, titled "Preoperative Medical Testing in Medicare Patients Undergoing Cataract Surgery." Cataract surgery, to replace a clouded lens in the eye, is the most common elective surgical procedure for elderly people; it is a safe and effective way to improve vision and is usually performed by an [...]

BILL HR4302 PASSES, ICD-10 IMPLEMENTATION DELAYED UNTIL OCT 1, 2015

         On April 1, President Obama signed into law a bill to delay the planned ICD-10 implementation until Oct. 1, 2015. Specifically, the bill prohibits CMS from enforcing a mandate to switch from ICD-9 to ICD-10 until Oct. 1, 2015. Details on implications to providers, health plans and technology companies in the health care industry are as yet unclear. Availity remains confident that we are prepared to accommodate any scenario that could unfold. We are committed to helping you operate a healthy, thriving business—even in an industry constantly redefined by change. Because we have solid yet flexible contingency plans for ICD-10 and other programs, you and your business will have the support you need. We are committed to preserving the uninterrupted flow of your administrative, clinical and financial information exchange on our networks, to assure continuous cash flow to your business. The Firm believes successful Physicians view their office as a business. In order to meet today’s healthcare needs of the patient, profits are critical for a Medical Practice to survive and thrive. As a trusted intermediary between payers, providers and other industry partners, the decision to delay the ICD-10 implementation will cause businesses to rethink their plans. As we consult with payers about their strategies, we will advise you on potential impacts to testing, training and implementation as soon as possible. The FIRM, with 30 years of combined experience specializes in Medical Billing, Credentialing and Consulting services to assist physicians and their staff to operate a more efficient, compliant and profitable medical practice. At The FIRM, optimal insurance reimbursement is our goal! The Firm’s expert medical billing staff understands the importance of excellent and efficient medical billing and collections as well [...]

Medical Billing – Credentialing- Insurance Claims Processing Management Professionals at The Firm Services

Medical Billing professionals at The Firm Services The FIRM provides professional claims billing services for individual providers, clinics and facilities. We service all disciplines of practice, i.e., medical, dental, diagnostic testing, chiropractic, physical therapy, optometry/ophthalmology, mental health, chemical dependency, and durable medical equipment. We offer specialty services such as consultation, collections and appeals, contracting and credentialing, verification and preauthorization and personal injury settlement negotiating. We offer form development and revision services, office reorganization and personnel training. Outsourcing your billing is advantageous and cost effective, consider the following key points: Minimal set up fee Cost of forms, paper, envelopes, postage, and ink for paper claims Cost and hassle for electronic claims submission Personnel costs to perform billing and fight denials Delays in billing and reimbursements: illness, vacation, unexpected absences, and termination of in-house staff Cost of ongoing training and education for billing personnel (claim and procedure changes), changes in codes, deletion of codes and other billing issues Unlimited, free support to answer questions and guide you The FIRM gives your billing undivided attention. The number one complaint from providers regardless of specialty concerning in house billing, is the billing persons’ constant interruptions, i.e., telephone, chart retrieval, assistance with patients, running off-site errands, filing, copying, faxing, etc. Practice analysis reports provided monthly, additional reports available upon request Remote access to your practices Credentialing Services:  Credentialing for all carriers including all necessary follow up and tracking to completion of process.FIRM CREDENTIALING Medical-Billing-Compliance-Checklist Professional and affordable credentialing to allow you to focus on patient care Reduce your billing issues due to improper credentialing. Changes in your practice or business status effect your reimbursement. The FIRM can identify problem areas and know how to properly execute those changes [...]

MEDICARE NEWS:

Congress Is Poised To Change Medicare Payment Policy. What Does That Mean For Patients And Doctors? Topics: Politics, Medicare, Delivery of Care, Health Costs By Mary Agnes Carey KHN Staff Writer Jan 16, 2014   After years of legislative wrangling and last-minute patches, expectations are high among physician groups, lawmakers and Medicare beneficiaries that Congress could act this year to permanently replace the current Medicare physician payment formula. While committees in both chambers have approved their own "doc fix" proposals, the approaches have yet to be reconciled, and none have identified how they would pay for a repeal. Below are some frequently asked questions and answers about the formula – known as the "sustainable growth rate" – and how Congress may change it. Q: What is the sustainable growth rate? A: Known as the SGR, the formula was created as part of a 1997 deficit reduction law designed to rein in federal health  by linking physician payment to an economic growth target. For the first few years after it was created, Medicare expenditures did not exceed the target and doctors received modest pay increases. But in 2002, doctors reacted with fury when they came in for a 4.8 percent pay cut. Every year since Congress has staved off the scheduled cuts. But each deferral just increased the size – and price tag – of the fix needed the next time. Q: What is Congress doing to scrap the SGR and what would they replace it with? A: Two committees in the House – the Energy and Commerce and Ways and Means panels – and the Senate Finance Committee have passed bills that would repeal the SGR and replace it with a system of rewarding physicians based [...]

OBAMACARE NEWS

Docs, Hospitals Cope With 'Trickle' Of Newly Insured Patients -- But Questions Continue About The Actual Number   Jan 16, 2014 As the Wall Street Journal reports that one of the biggest issues right now is making sure these newly insured people have insurance cards, other news outlets detail reports and questions about the number of enrollees. The Wall Street Journal: Two Weeks Into Health Law’s Rollout, Few Problems, Few Patients Two weeks into the full rollout of the Affordable Care Act, hospitals and doctors say they are coping with the trickle of new patients relatively smoothly, but one of the biggest issues is making sure enrollees get insurance cards. The 2010 health law represented the biggest expansion of insurance coverage in a generation. Nonetheless, the number of people signing up so far for private coverage or Medicaid under the law is still a tiny fraction of all Americans with health insurance, partly because computer snafus hindered early enrollment (Corbett Dooren and Beck, 1/16). The Washington Post’s The Fact Checker: Warning: Ignore Claims That 3.9 Million People Signed Up For Medicaid Because Of Obamacare There is much less to the Medicaid figure than meets the eye. (The exchange figure has been updated recently, to 2.2 million, but not the Medicaid figure.) Indeed, there has been vast confusion about what this figure means, especially in the news media. The Fact Checker cited the 3.9 million figure in a few recent columns, but prodded by an interesting analysis by Sean Trende at Real Clear Politics, we decided to take a closer look (Kessler, 1/16). Kaiser Health News: Capsules: State Snapshots Of Obamacare Enrollment Numbers Enrollment in the health law’s marketplaces surged in December, and the administration’s report on the [...]

AFFORDABLE CARE ACT

Key Features of the Affordable Care Act You will soon have access to health coverage, even if you have a pre-existing condition. And premium tax credits and other financial assistance will help you pay for health insurance if you are eligible. Below are some things you should know about the Affordable Care Act. If you want to get more detailed information about the new health care law, read about each of the provisions. The Health Insurance Marketplace offers a new way to shop and enroll in a health plan. Preventive services will have no out-of-pocket costs. Essential health benefits will be included in most health insurance plans. You can keep your adult children on your health insurance plan up to the age of 26. You choose your doctor. Emergency access is guaranteed. Health coverage is easier to understand. You can appeal if coverage is denied.  

Medical Billing ? Credentialing? The Firm Services has your answers.

Our mission is to provide professional, state of the art medical billing and specialty services to our clients to achieve maximum reimbursement. The Firm believes successful Physicians view their office as a business. In order to meet today’s healthcare needs of the patient, profits are critical for a Medical Practice to survive and thrive. FIRMSERVICESMEDICALBILLINGINSURANCECLAIMSThe FIRM, with 30 years of combined experience specializes in Medical Billing, Credentialing and Consulting services to assist physicians and their staff to operate a more efficient, compliant and profitable medical practice. At The FIRM, optimal insurance reimbursement is our goal! The Firm’s expert medical billing staff understands the importance of excellent and efficient medical billing and collections as well as effective denial appeals. Continuing Education at The FIRM is the key to understanding and keeping abreast of the continuously changing federal and State laws & regulations that can affect our clients. The FIRM serves physicians and physicians groups nationwide in all medical specialties including; Audiology Cardiology Chiropractic DME Family Practice Internal Medicine Neurology Occupational Therapy and Speech Language Pathology Pain Management Plastic Surgery Physical Therapy Podiatry Mental health Radiology Pain Management The Firm offers premier expertise, services, resources, and support for: CREDENTIALING AND CONTRACTING Medicare / Medicaid, Blue Cross Blue Shield, Cigna, UHC, Multiplan, Humana, Aetna, Coventry, Scott & White The FIRM understands the importance of proper credentialing and contracting and how it impacts your income. Through the years, building strong relationships with many insurance companies and provider enrollment representatives across the country, The FIRM can help you the provider save valuable time and money during the credentialing process. *NPI PROFILE Group or Individual An accurate and updated NPI Profile is critical to Medicare enrollment and payments. *CAQH An updated [...]

They Are Warriors of All Things Medical

Stacy King wrote a great article about The FIRM, take a look: