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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.


Experimental Obamacare health plan exits Chicago and Atlanta markets

CNBC -Dan Mangan | @_DanMangan September 30,2016 This Obamacare experiment is a flop. Harken Health — billed as an "innovative" health insurer and started by America's biggest insurance company to appeal to Obamacare customers — will exit the only two government-run exchange markets where it was selling coverage after reportedly booking losses of about $70 million in the first half of this year. The UnitedHealth Group unit — which offers unlimited primary care visits at no out-of-pocket cost to customers who use Harken Health clinics — will reportedly continue selling plans outside of Obamacare exchanges in the individual and employer markets of both Chicago and Atlanta next year. But its departure in 2017 from the Obamacare exchanges that serve those cities represents another setback for advocates of the Affordable Care Act and their efforts to offer individual health plan customers a broad range of affordable coverage options. Harken in August said it was abandoning plans to sell Obamacare exchange coverage in Miami and Fort Lauderdale, Florida, next year. And Harken's parent, UnitedHealth, earlier this year said it would itself exit most Obamacare exchanges, including the federal marketplace that services Illinois, in 2017. The Chicago Tribune noted that because of Harken's exit, residents of Cook County, which includes Chicago, will have just three insurers to choose from if they want to buy coverage on, the federal Obamacare exchange that serves Illinois and 37 other states. and state-run Obamacare exchanges are the only places that low- and moderate-income customers receive subsidies, in the form of federal tax credits, to lower the cost of their monthly premiums. The subsidies, whose amounts are linked to income levels and the premium charges, can significantly reduce the cost of [...]

Nine ICD-10 update tips

The Firm Services your best resource for ICD-10 issues ICD 10 Watch- September 23,2016 It's less than two weeks before U.S. healthcare providers are expected to use more updated ICD-10-CM/PCS. Update patient intake forms, insurance forms and superbills to include ICD-10 specificity. Make sure those forms aren't encouraging less specific ICD-10 codes. Lookup codes instead of relying on ICD-9 to ICD-10 code maps. By nature, code maps and crosswalks lead to less specific codes. Start choosing more specific alternatives. Reinforce ICD-10 training. Focus on learning how to code the most used diagnoses. Make sure electronic health record (EHR) forms and billing software are updated. Call your vendors and test the updates as soon as possible. Look for any trends with unspecified diagnosis codes. When and where are the unspecified ICD-10 codes being used? What can be done to make ICD-10 codes more specific? Review use of unspecified codes in top diagnoses. It's worth the time making sure more specific diagnoses are being assigned. Make sure clinical documentation can support more specificity in coding. Medical coders cannot assign specific ICD-10 codes if clinicians are not documenting the details needed. Review the ICD-10 guidelines. There are more than codes to update. Track denials. Maybe healthcare payers already are requring more specific ICD-10 codes. Some basic steps will make sure ICD-10 coding remains manageable after Oct. 1. Questions about ICD-10 codes and reimbursement? Physician Credentialing and Revalidation ? or other changes in Medicare, Commercial Insurance, and Medicaid billing, credentialing and payments? Call the Firm Services at 512-243-6844 

Obama steps in to save Obamacare

With no lifeline coming from the divided Congress, the administration is redoubling pleas for insurers to shore up the federal health care law. Politico By Paul Demko 09/16/16 05:22 AM EDT Deep into the final year of his presidency, Barack Obama is working behind the scenes to secure Obamacare’s legacy, struggling to bolster a program whose ultimate success or failure will likely be determined by his successor. With no lifeline coming from the divided Congress, Obama and his administration are redoubling their pleas for insurers to shore up the federal health care law and pushing uninsured Americans — especially younger ones — to sign up for coverage. The administration is nervously preparing for its final Obamacare open-enrollment season just a week before Election Day, amid a cascade of headlines about rising premiums, fleeing insurers and narrowing insurance options. On Monday, Obama met face to face at the White House with leading insurance executives, asking for their continued commitment to the health law despite its recent spate of difficulties. Insurers have come to the White House periodically as the law has rolled out; this time the president made a direct plea for their ongoing support. They in turn pressed their case for steps the administration can still take to strengthen the Obamacare markets. Notably absent were two of the national insurers that have already bailed on most Obamacare marketplaces — Aetna and UnitedHealth Group. “We know that this progress has not been without challenges,” Obama wrote this week to each insurer selling Obamacare plans. “Most new enterprises have growing pains and opportunities for improvement. The Marketplace, while strong, is no exception. Time and experience will help drive that improvement, as will constructive policy changes.” Meanwhile, the administration [...]

Dems use ObamaCare crisis to revive ‘public option’ push

By Barnini Chakraborty Published September 07, 2016 President Obama and his Democratic allies are seizing on the exodus of private insurers from ObamaCare markets to renew their push for a so-called "public option" -- but Republicans say more "government intervention" is not the answer to the latest Affordable Care Act woes. A public option -- or insurance plan offered by the government -- had been written into early versions of the bill but failed to make the final cut in the law signed by Obama in March 2010. But with many states seeing private insurers exit ObamaCare markets amid concerns over cost and other factors, Democrats see a silver lining to what critics are calling another ObamaCare crisis -- a reason to bring the option back. “Now, based on experience with the ACA, I think Congress should revisit a public plan to compete alongside private insurers in areas of the country where competition is limited,” Obama wrote last month in the Journal of the American Medical Association. The president called on his White House successor and Congress to implement the option. A former Obama health official, Ezekiel Emanuel, also backed up the president in a recent op-ed. And ex-Obama campaign manager David Plouffe added his support in an interview with NBC's "Meet the Press." If elected, Democratic presidential nominee Hillary Clinton says she’ll look for ways to improve ObamaCare, which includes supporting a public option. Her Republican rival Donald Trump and several GOP lawmakers, though, say the public option isn’t an option at all. Sen. John McCain, R-Ariz., who is seeking a 6th term, has been a vocal opponent of ObamaCare from the start and maintains “the whole thing is collapsing like a house [...]