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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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Tech company once lauded for growth shutters Tampa office suddenly, leaves over 100 without jobs

By Janelle Irwin – Reporter, Tampa Bay Business Journal-Jun 21, 2018, 6:55pm EDT Updated Jun 22, 2018, 12:47pm Health care technology firm CareSync closed its doors on Thursday despite previously announced plans to hire 350 people by the end of 2017 and expand its Tampa headquarters. A manager with the company, who spoke on the condition of anonymity, told the Tampa Bay Business Journal that there had been several rounds of layoffs in recent weeks, but that a plan to sell the company gave remaining employees hope their jobs would remain intact. The employee said a deal fell through and the company had been “bleeding money” the past several weeks. The company's Twitter and Facebook pages were both taken down Thursday evening. Employees at the Tampa and Hardee County offices were told Thursday to pack up their things and leave and that the business was closing permanently. The employee said the company was not offering COBRA benefits to employees and that existing health coverage would be terminated immediately. Employees were also not offered severance. “It really saddens me and most of us because we were blindsided,” Kathy Clem, who identified as an employee, lamented on Facebook. “Someone was supposed to buy the company, but it fell through." Multiple sources said the closure was the result of a buyout by internet-based grocery delivery company Shipt falling through. A request for comment from Shipt was not immediately returned. In December 2017, Target Corp. acquired Shipt. (Update: Shipt CEO Bill Smith was personally going to buy CareSync. Read more here.) In 2014, CareSync moved into 51,000 square feet at 14055 Riveredge Drive in the Hidden River Corporate Park, and brought with it 150 jobs, planning to reach a [...]

By |June 28th, 2018|Blog, Commercial Insurance, Doctor, doctor, doctor Credentialing, Healthcare Changes, Healthcare Professionals, Medicaid, Medical Billing, Medical Coding, Medical Compliance, Medical Credentialing, Medical Insurance, Medicare, Medicare, medicare claims, Obamacare, Physical Therapy, Physician Credentialing|Comments Off on Tech company once lauded for growth shutters Tampa office suddenly, leaves over 100 without jobs

House GOP plan would cut Medicare, Medicaid to balance budget

Washington Post -  Erica Werner -June 19 at 4:48 PM House Republicans released a proposal Tuesday that would balance the budget in nine years — but only by making large cuts to entitlement programs, including Medicare, that President Trump vowed not to touch. The House Budget Committee is aiming to pass the blueprint this week, but that may be as far as it goes this midterm election year. It is not clear that GOP leaders will put the document on the House floor for a vote, and even if it were to pass the House, the budget would have little impact on actual spending levels. Nonetheless the budget serves as an expression of Republicans’ priorities at a time of rapidly rising deficits and debt. Although the nation’s growing indebtedness has been exacerbated by the GOP’s own policy decisions — including the new tax law, which most analyses say will add at least $1 trillion to the debt — Republicans on the Budget Committee said they felt a responsibility to put the nation on a sounder fiscal trajectory. “The time is now for our Congress to step up and confront the biggest challenge to our society,” said House Budget Chairman Steve Womack (R-Ark.). “There is not a bigger enemy on the domestic side than the debt and deficits.” The Republican budget confronts this enemy by taking a whack at entitlement spending. Lawmakers of both parties agree that spending that is not subject to Congress’s annual appropriations process is becoming unsustainable. But Trump has largely taken it off the table by refusing to touch Medicare or Social Security, and Democrats have little interest in addressing it except as part of a larger deal including tax increases — [...]

New Medicare Advantage rules hold big potential for pop health

Healthcare Dive- Meg Bryant- June 13, 2018 The push toward valued-based care and population health management has raised visibility around nonmedical conditions that impact health outcomes. Improving health outcomes using population health strategies could get a major boost with a new Medicare Advantage rule taking effect this week. Payers will now be able to work with companies like Uber or Lyft to provide transportation, for example, as part of a more complete set of benefits for the quickly growing MA population. CMS issued a final rule in May giving MA plans more flexibility in determining the types of supplemental benefits they can offer chronically ill enrollees, including nonmedical benefits. The new policy, part of a broad 2019 Medicare payment rule, means plans like UnitedHealthcare and Humana aren't harnessed to a set palette of supplemental benefits for members with chronic conditions, but can tailor them to the specific needs of individuals. The rule could see an array of new benefits aimed at improving health outcomes by addressing issues such as housing and food insecurity, transportation and social isolation. Potential benefits include ride-hailing services, home visits, nutritional support, air conditioners for people with asthma, home renovations like grab bars and other accommodations to prevent falls, and home health aides. Providers have praised the expansion of benefits. “We now have a funding stream effectively within Medicare Advantage around social services,” Don Crane, president and CEO of America’s Physician Groups (APG), told Healthcare Dive in an interview. He called the change a “necessary and appropriate step” in managing chronic diseases. The focus on social determinants of health and population health management is part of the broader shift to value-based care and reimbursement. Some providers, payers and employers already offer wellness and prevention programs or [...]

Medicare Advantage Change Could Lead To Payments Opportunities

PYMNTS - June 7, 2018 One of the latest changes to federal rules regarding non-medical home care services could provide more business opportunity to firms that serve that market and handle such backend tasks as billing and payroll. In April, the U.S. Centers for Medicare and Medicaid Services (CMS) said that Medicare Advantage would, for the first time, cover those services, through which caregivers help senior citizens in their homes. The decision allows that care to be treated as a supplemental benefit under Medicare Advantage programs. “CMS is expanding the definition of ‘primarily health related’,” the federal agency said. “Under the new definition, the agency will allow supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions and/or reduce avoidable emergency room utilization.” According to the CMS, 35 percent of Medicare beneficiaries take part in Medicare Advantage, with experts predicting significant increases in the years to come. “Insurers and payors have been positioning themselves to better align with post-acute care services for years. As the focus also shifts toward the high-cost, high-needs, dual-eligible patient populations of people who qualify for both Medicare and Medicaid, that has provided additional incentive to cover personal care services as well,” reported Home Health Care News. This is a significant deal for seniors, because they usually pay out of pocket for non-medical home care services, according to experts. And it could turn into a lucrative opportunity for companies active in this market, too. One such company, called Honor, partners with local home care agencies and other providers to manage such tasks as caregiver payroll, recruiting, scheduling, insurance and legal issues. In May, the company accounted a $50 million Series C funding round led by [...]