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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.

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Amazon’s cloud is about to announce a huge health-care deal with Cerner

CNBC- Christina Farr | Jordan Novet Published 11:21 AM ET Wed, 22 Nov 2017 Updated 1:22 PM ET Wed, 22 Nov 2017 Amazon's cloud unit to partner with Cerner: Sources Amazon's cloud unit to partner with Cerner: Sources say Amazon's cloud business, in its march toward $20 billion in annual revenue, has nabbed top clients in areas ranging from energy and technology to financial services and government. Heading into its annual re:Invent conference in Las Vegas next week, Amazon Web Services has found a partner to help the company crack a massive industry that's been slower to adopt the cloud: health care. As part of his keynote at re:Invent, AWS CEO Andy Jassy is planning to announce that Amazon is teaming up with Cerner, one of the world's largest health technology companies, to help health-care providers better use their data to make health predictions about patient populations, according to sources familiar with the matter. The sources, who asked not to be named because the discussions are still in the final stages, said the partnership is initially focused on Cerner's so-called population health product — HealtheIntent — which enables hospitals to gather and analyze huge volumes of clinical data to improve patients' health outcomes and lower treatment costs. Cerner did not provide a comment for this story, and AWS representatives didn't respond to requests for comment. In addition to its health investments, AWS has sought to expand its push into the public sector. Earlier this week it announced plans for a group of cloud data centers for the CIA and other U.S. intelligence community members. Relative to most industries, hospitals and other health providers have resisted the shift from traditional data centers to the cloud because of [...]

I.R.S. Starts to Enforce Health Law’s Rule That Employers Offer Insurance

NY TIMES- By STACY COWLEY NOV. 16, 2017 As Republicans and the Trump administration continue trying to chip away at the Affordable Care Act, the Internal Revenue Service has begun, for the first time, to enforce one of the law’s most polarizing provisions: the employer mandate. Thousands of businesses — many of them small or midsize — will soon receive a letter saying that they owe the government money because they failed to offer their workers qualifying health insurance. The first round of notices, which the I.R.S. began sending late last month, are being mailed to companies that have at least 100 full-time employees and ran afoul of the law in 2015, the year that the mandate took effect. Large companies, defined in the law as those with 50 or more workers, are required to offer their employees affordable insurance or pay stiff tax penalties. The I.R.S. held off for years on assessing those fines, saying that it needed more time, and money, to build its compliance systems. Now, the agency says it is finally ready to go after scofflaws. “As the I.R.S. has publicly stated, the agency is obligated to enforce the Affordable Care Act’s employer shared responsibility provision,” said Bruce Friedland, an agency spokesman. Ten months ago, in his first executive order, President Trump directed government agencies to waive, defer or delay carrying out as much of the law as possible. This week, the Treasury Department said that it objected to the employer mandate but was legally compelled to enforce it. “Treasury lawyers see no ground for the secretary to direct the I.R.S. to not collect the tax,” the agency said in a written statement. “The A.C.A.’s employer mandate unfortunately remains the law of [...]

By |November 16th, 2017|Blog, Credentialing, doctor, doctor Credentialing, Healthcare Changes, Healthcare Professionals, ICD-10, Medical Billing, Medical Coding, Medical Credentialing, Medical Insurance, Medicare, medicare claims, Physician Credentialing|Comments Off on I.R.S. Starts to Enforce Health Law’s Rule That Employers Offer Insurance

Insurers make billions off Medicaid in California during Obamacare expansion

Los Angeles Times - Chad Terhune and Anna Gorman- NOVEMBER 6, 2017 Medicaid is rarely associated with getting rich. The patients are poor, the budgets tight and payments to doctors often paltry. But some insurance companies are reaping spectacular profits off the taxpayer-funded program in California, even when the state finds that patient care is subpar. Health Net, a unit of Centene Corp., the largest Medicaid insurer nationwide, raked in $1.1 billion in profit from 2014 to 2016, according to state data obtained by Kaiser Health News. Anthem, another industry giant, turned a profit of $549 million from California’s Medicaid program in the same period. Overall, Medicaid insurers in the Golden State made $5.4 billion in profits from 2014 to 2016, in part because the state paid higher rates during the inaugural years of the nation’s Medicaid expansion under the Affordable Care Act, or Obamacare. Last year, they made more money than all Medicaid insurers combined in 34 other states with managed care plans. “Those profits are gigantic — wow,” said Glenn Melnick, a health economist and professor at USC. Alan Sager, a health-policy professor at Boston University, was surprised — and dismayed. “California is being wildly open handed and excessively generous with insurers,” he said. Jennifer Kent, California’s Medicaid director, said that health plan profits were higher than anticipated during the ACA expansion. But she said the state expects to recoup a significant amount of money within the next year once audits are complete and other retroactive rate adjustments are made. “We’re going to be taking a lot of money back. We’re talking billions of dollars,” Kent said in an interview Friday. No one should think “these plans just made off like bandits and [...]

By |November 9th, 2017|Blog, Commercial Insurance, Credentialing, doctor, doctor Credentialing, Healthcare Professionals, Medicaid, Medical Coding, Medical Compliance, Medical Credentialing, Medical Insurance, Medicare, Medicare, medicare claims, Obamacare, Physician Credentialing|Comments Off on Insurers make billions off Medicaid in California during Obamacare expansion

Tax bill will not seek repeal of individual health insurance mandate

The Hill- BY PETER SULLIVAN - 11/02/17 09:51 AM EDT The tax reform bill to be released Thursday will not include a repeal of ObamaCare's individual mandate, sources say, despite President Trump proposing the idea on Wednesday. Repealing the mandate would introduce a whole new area of controversy into the bill, and many Republicans think tax reform is hard enough without adding in health care. Still, it is possible the idea could come back down the road, given that some Republicans are still pushing. Rep. Kristi Noem (R-S.D.), a member of the House Ways and Means Committee, said Wednesday night that she did not think mandate repeal would be included "just because we didn't have unanimous agreement on the committee." Sen. Tom Cotton (R-Ark.) has been the main proponent of the idea and talked with Trump about it over the weekend. Repealing the mandate would save around $400 billion, which could be used to help pay for tax cuts, but the Congressional Budget Office also says 15 million more people would be uninsured and premiums would rise 20 percent. Ways and Means Committee Chairman Kevin Brady (R-Texas) said earlier this week, though, that he did not want to include mandate repeal because he fears it will jeopardize the tax bill since the Senate has been unable to deliver on health-care reform. Rep. Mark Meadows (R-N.C.), the chairman of the conservative House Freedom Caucus, said Wednesday night that he would push for including mandate repeal and that he thought "ultimately" it would be included in the bill. Meadows said he has talked to Cotton. Rep. Mark Walker (R-N.C.), the conservative Republican Study Committee chairman, said he had discussed the idea at an RSC meeting with National Economic [...]

By |November 2nd, 2017|Blog, Consulting, doctor, doctor Credentialing, Healthcare Professionals, ICD-10, Medical Billing, Medical Coding, Medical Compliance, Medical Credentialing, Medical Insurance, Medicare, medicare claims, Obamacare, Physician Credentialing|Comments Off on Tax bill will not seek repeal of individual health insurance mandate