Tag Archives: provider

What We’re Reading – Top 10 Changes in Patient Expectations (Part I)

Undoubtedly, the first rule of customer service is to find out what your customers want and then to give it to them.  This article’s author states that, “Understanding how patient expectations and behaviors have changed is the first step toward … Read Full Post

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The Revalidation of Provider Enrollment Information

The revalidation process is a requirement of the Affordable Care Act for all Medicare providers and suppliers to revalidate their enrollment information in the Medicare program under new enrollment screening criteria.  The revalidation process affects only those Medicare providers who … Read Full Post

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How does provider reimbursement work?

There are two common methods of reimbursing physicians: Fee-for- service (FFS) and capitation. There are also two major code categories in use by most primary care physicians: ICD-9-CM codes and CPT-4 & HCPCS codes. ICD-9-CM codes (soon to be replaced … Read Full Post

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What is MRA?

MRA – Medicare Risk Adjustment – was established in 2003 and phased in over a five year period. Through this payment methodology, the MedicareAdvantage Plan’s (and the provider’s) capitation is adjusted based on the risk assumed for the patient’s care, … Read Full Post

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