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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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Did Medicaid Expansion Cause The Opioid Epidemic? There’s Little Evidence That It Did.

Health Affairs Blog- Andrew Goodman-Bacon and Emma Sandoe -August 23, 2017 Recent health reform debates have generated a new theory that claims that the Affordable Care Act’s (ACA) Medicaid expansion has either caused or exacerbated the opioid epidemic. The logic on its face seems clear: legal prescriptions fuel the opioid epidemic, Medicaid increases access to prescription opioids, hence the Medicaid expansion contributes to, or has even caused the epidemic. Proponents of this view point to a rise in opioid-related deaths in ACA Medicaid expansion states relative to non-expansion states. Political commentators, including some politicians, use this claim to justify their support for federal Medicaid cuts, despite the fact that Medicaid finances a significant amount of treatment for opioid use disorder. In this post, we argue that evidence for the claim that the ACA’s Medicaid expansion caused or exacerbated the opioid epidemic is not credible. First, trends in opioid deaths nationally and by Medicaid expansion status predate the ACA. Second, counties with the largest coverage gains actually experienced smaller increases in drug-related mortality than counties with smaller coverage gains. Third, the fact that Medicaid recipients fill more opioid prescriptions than non-recipients largely reflects greater levels of disability and chronic illness in the populations that Medicaid serves. While we do not reject the possibility that public policy has played a role in our current prescription abuse crisis, on balance we find little evidence to support the idea that Medicaid caused or worsened the epidemic. Existing Evidence On Medicaid And Opioids Comparing Medicaid Recipients To Non-Recipients Proponents of the view that Medicaid exacerbates drug abuse often cite the fact that Medicaid recipients are prescribed more opioids than non-recipients. In the early 2000s, for example, Medicaid enrollees in New York [...]

Poll: Most older Americans want Medicare to cover long-term care

Confused about Medicare / Medicaid issues? Ask the experts at The Firm Services CBS News- AP / May 26, 2017, 7:44 AM WASHINGTON -- A growing number of Americans age 40 and older think Medicare should cover the costs of long-term care for older adults, according to a poll conducted by the Associated Press-NORC Center for Public Affairs Research. That option is unlikely to gain much traction as President Donald Trump's administration and Republicans in Congress look to cut the federal budget and repeal President Barack Obama's 2010 health care law. Most older Americans mistakenly believe they can rely on Medicare already for such care, the poll shows, while few have done much planning for their own long-term care. Things to know from the AP-NORC poll of older adults: MOST WANT MEDICARE TO PAY More than half of older Americans - 56 percent - think the federal government should devote a great deal or a lot of effort to helping people with the costs of long-term care, and another 30 percent think it should make a moderate effort to do so. According to the poll, 56 percent of Americans age 40 and over think Medicare should have a major role in paying for ongoing living assistance, up from 39 percent who said so in 2013. Majorities of both Democrats and Republicans now think Medicare should bear a large part of the burden. The poll has other signs of growing support for government involvement in providing long-term care. Seventy percent of older Americans say they favor a government-administered long-term care insurance program, up from 53 percent who said so a year ago. Most also favor tax policies to encourage long-term care planning, including tax breaks [...]

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: