Addiction, addiction-treatment / 24.09.2024

The decision to start rehab is a huge one, and the last thing you want to worry about is how to pay for it. Unfortunately, merely having insurance doesn't guarantee the policy covers treatment in a rehab facility. According to a study published by the National Library of Medicine, approximately 39% of individuals who seek addiction treatment face issues with insurance coverage, whether it's limited coverage or complete denial. For that reason, knowing what it covers (and doesn't) ahead of time can make a big difference, regardless of whether you're getting treatment or a family member. Let's break down what you need to know about rehab insurance, so you and your loved one can focus on what matters most—getting better. (more…)
Medicare / 20.09.2024

  Using Medicare can be quite challenging for those without experience dealing with this system and its numerous programs, plans, and services. Hiring a Medicare insurance agent is one of the best ways to guarantee that you get the right Medicare plan suitable for your needs. However, the problem of choosing the right agent might be even more daunting than the task of comprehending the insurance plans. This guide is designed to help you select the best Medicare insurance agent and make the right decision. (more…)
Abuse and Neglect, Cost of Health Care, Race/Ethnic Diversity / 06.08.2024

MedicalResearch.com Interview with: Benjamin Ukert PhD Assistant Professor Department of Health Policy and Management Texas A&M University, School of Public Health Texas 77843-1266 MedicalResearch.com: What is the background for this study? Response: The Affordable Care Act (ACA) was enacted in March 2010 with one major goal to increase access to insurance coverage. This was done through the expansion of the Medicaid program for low income individuals and the establishment of formal health insurance marketplaces for individuals without access to employer sponsored insurance. Texas did not expand Medicaid for low income individuals, but the health insurance marketplace should have led to increases in insurance coverage, due to generous federal subsidies that cover a large share of the health insurance premium. Gaining insurance coverage can affect providers, such as hospitals, who treat a large share of uninsured individuals. We focused on the inpatient setting and evaluated whether the ACA led to changes in demand for hospital care, and whether the ACA led to reduction in the share of uninsured individuals treated by hospitals. (more…)
Cost of Health Care, Medical Billing / 04.07.2024

Patient insurance coverage frequently changes, which can lead to missed details when tracked manually. This often results in claim denials and subsequent reimbursement issues. This article explores the benefits and effectiveness of automated eligibility coverage tracking platforms designed to address these challenges effectively.

The Problem: Manual Tracking Just Doesn't Cut It Anymore

Determining a patient’s status as well as his or her insurance is a crucial but time-consuming process in the billing department. Previously, it included calling insurance companies, verifying the data in different systems, and entering the information into spreadsheets. Since patient details are dynamic and various claims need to be addressed every week, it becomes impossible to manage information updates through traditional methods. Some of the problems include:
  • Time-Consuming Process - Verifying coverage manually can take up to 30 minutes per patient. For large billing companies, this may translate into big time losses.
  • Human Error - Manually compiling and updating records inevitably leads to inaccurate or outdated information falling through the cracks.
  • Claim Denials - Incorrect policy details lead to higher denial rates, payment delays and lost revenue.
  • Lack of Visibility - With records scattered across systems and spreadsheets, billing teams lack clear visibility into coverage changes.
Traditional ways of checking eligibility can't keep up with increasing patient numbers and complexity. Billing teams handling medical billing denials and solutions urgently require automation support to manage this crucial data. (more…)