Outsourcing Medical Billing

When a practice upgrades its clinical workflow say, moving from a platform like TherapyNotes to a system like Jane, backed by a clearinghouse like ClaimMD there is usually a lot of excitement. You look forward to cleaner interfaces, better scheduling, and fresh features. You check the boxes to link your new clearinghouse, hit submit on a few test claims, see them go through successfully, and assume the transition is complete. Then, two weeks pass. You know you’ve had claims p

It’s a scenario that makes every private practice owner’s stomach drop. You pull your weekly remittance advice, expecting a healthy reimbursement for a complex patient session where you billed multiple units or multiple distinct codes. Instead, the payment that hits your account is a fraction of what you calculated. Your first instinct? Call it an underpayment, blame a payer glitch, and gear up for a timely filing appeal. But before you spend hours on hold or drafting appeal

By Danielle Wagar, CPES | Upstate Healthcare Admin Blue Cross Blue Shield is not a single insurance company. This is the thing most providers do not fully understand when they get credentialed with their local BCBS plan - and it is why BCBS claims can behave so differently depending on the patient in front of you. BCBS is a federation of 33 independent, locally operated member plans. When your patient has a BCBS plan from another state, the BlueCard Program governs how their

Are you spending too much time on insurance claims? Learn when to hire a fractional 1099 medical biller to increase your clinical income and end the admin struggle.