Telehealth: the best idea that may never happen

Posted by Michael Renzi, DO, FACP on Mar 7, 2017 11:02:00 AM

Telehealth is the wave of the future for PHM and VBC—but who’s going to pay?

When it comes to defining the factors that will have the biggest impact on the future of healthcare in the United States, it’s no wonder that connected care is among them.  As our technology improves and new devices hit the market seemingly every week, the ability to capitalize on these innovations to improve care delivery and patient engagement is a no-brainer.

But, two questions come up when I talk to my clinical colleagues: Should I offer telehealth services, and how can I pay for them? My answers: yes, and maybe try a tip jar at the front desk.

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Topics: payer reimbursement, Telehealth, Telemedicine

Tips to Maximize ICD-10 Coding Reimbursements

Posted by Continuum on Apr 27, 2016 4:28:14 PM

ICD-10: three letters and two numbers that caused much anxiety and stress for the medical community.                           Continuum’s coding team effectively prepared its clients for a smooth transition with little incident. It took approximately two years of hard work to prepare for the update to ICD-10, which went into effect in October 2015.

While it's been only six months, experts say much of the trepidation and hype were oveblown. The fear of denials, lost revenue, and work flow is nowhere to be seen.

A Physicians Practice survey revealed that 47.3 percent of readers say they are having no problems with the ICD-10 transition and have not seen an increase in claims rejections. Another survey found that 60 percent of practices said they have not seen an impact on monthly revenue1.

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Topics: coding, icd-10, payer reimbursement

Continuum Service Spotlight: Credentialing

Posted by Continuum on Apr 12, 2016 11:00:00 AM

A Quick Overview

Physician practices often underestimate the importance (and timing) of credentialing, the process of maintaining medical credentials and privileges for all providers. Continuum’s Credentialing team handles the initial licensure and all renewals, ensures that all providers are enrolled with payers and receive privileging at area hospitals, confirms National Provider Data Bank (NPDB) status, and tracks all items with regular expirations, such as malpractice insurance, certifications and licenses.

Advance Planning & Meticulous Records Are Key

During the second quarter of the year, Continuum’s Credentialing team often sees a flurry of activity, as practices hire providers completing their residency in June. A new provider will take approximately 120 days to credential from the time they complete their residency, since payers have no record of them in their system. If all required submission elements are ready and the licensing is granted quickly, the process could be accelerated to 90 days.

Providers obtaining credentials for the first time or who are joining a new practice should provide the following information:

  • CDS: A Controlled Dangerous Substance license (many providers are unaware this is required)
  • DEA number: The Drug Enforcement Administration number allows providers to prescribe medications
  • NJ License: New physicians or those coming from another state must have a NJ License, which generally takes a minimum of four to six weeks
  • Continuum also requests access to the provider’s Council for Affordable Quality Healthcare (CAQH) account, which allows the team to review existing documentation within the preferred database of most insurance companies
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Topics: credentialing, payer reimbursement

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