Navigating the Business of Medicine
Navigating the Business of Medicine
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The Hidden Costs of Hiring Inexperienced Staff
Hiring inexperienced staff may seem cost-effective upfront, but errors and inefficiencies often lead to greater long-term expenses. This highlights the importance of investing in experienced employees from the start.
Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-contracting
Don't forget to like, subscribe, and share this video with your colleagues. We appreciate your support!
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📚 Looking for more in-depth knowledge? Explore our blog for a wealth of articles on Medical Practice Management, Contracting and credentialing, and more: integralclinicsolutions.com/blog
Hi there! My name is Jennifer. Over the last 20 years, I've gained much experience working in the medical field in various roles. Through my experience, I've seen many medical practice owners make mistakes in running their businesses. That's why I created this channel - to help medical practice owners avoid these common pitfalls. I aim to promote growth and success within the private practice world of medicine. Healthcare has become too standardized, creating many unnecessary challenges and demands.
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Переглядів: 29

Відео

Breaking Down the 2025 CMS Final Rule: Key Changes for Medicare Providers
Переглядів 52012 годин тому
The 2025 CMS Final Rule introduces expanded behavioral health coverage, a reduced Medicare reimbursement conversion factor, and new caregiver training standards, which will impact Medicare providers starting January 1, 2025. Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialin...
Why Ignoring Refunds Could Be Costing Your Practice Big Time!
Переглядів 37День тому
Learn how managing patient and insurance refunds can strengthen your revenue cycle, improve accuracy, and keep your practice compliant! Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-contracting Be sure to check out the full blog post for more details and insights -...
Improving Patient Communication: Tips for a Connected and Satisfied Practice
Переглядів 37День тому
Discover how modern communication tools like patient portals and text messaging can transform your practice, boost patient satisfaction, and streamline your workflow. Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-contracting Be sure to check out the full blog post ...
Clean Desk Policy: Essential HIPAA Compliance for Your Practice
Переглядів 5614 днів тому
Learn how a Clean Desk Policy can safeguard patient data and ensure HIPAA compliance in your practice-watch now for essential tips! Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-contracting Be sure to check out the full blog post for more details and insights - int...
Revenue Cycle Disruptions: Switching Billing Companies and EMR Systems
Переглядів 7114 днів тому
Learn the essential steps and potential pitfalls of switching billing companies or EMR systems to keep your practice's revenue cycle running smoothly during transitions! Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-contracting Don't forget to like, subscribe, and ...
How Outdated Patient Data Can Harm Your Practice - and How to Fix It
Переглядів 3921 день тому
Learn how keeping patient information up to date can save your practice time, improve communication, and prevent costly mistakes as we head into deductible season! Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-contracting Don't forget to like, subscribe, and share ...
Payer Policies Made Easy: Blue Cross Blue Shield of Oregon Walkthrough
Переглядів 6021 день тому
Discover how to easily navigate and use payer policies online, with a step-by-step guide featuring Blue Cross Blue Shield of Oregon-perfect for billing, coding, and healthcare professionals! Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-contracting Don't forget to ...
Stop Wasting Money! Essential Tips to Control Medical Practice Expenses
Переглядів 95Місяць тому
Learn how to avoid unnecessary expenditures when starting a medical practice, with practical tips on saving costs while maintaining quality care-watch now for smart budgeting strategies! Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-contracting Be sure to check out...
Expand Your Practice Across State Lines: The Power of the IMLC
Переглядів 118Місяць тому
Learn all about the Interstate Medical Licensure Compact (IMLC), an expedited pathway for physicians to obtain licenses in multiple states. Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-contracting A link to the website can be found below for your reference under "...
The Real Impact of Marketplace Insurance on Private Practices
Переглядів 110Місяць тому
Explore the pros and cons of healthcare exchange (Obamacare) insurance for small private practices in my latest video, and learn how to navigate the challenges during open enrollment-watch now! Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and- Sign up for free Credent...
The Importance of Backing-up Important Documents
Переглядів 40Місяць тому
Don't overlook the importance of backing up your work! Learn why it's crucial to store essential practice documents on both cloud and physical devices to protect against data loss and ensure quick access when needed. Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-co...
CPT Codes 101: Breaking Down Categories 1, 2, and 3
Переглядів 115Місяць тому
Many people in the healthcare industry may not be aware that multiple types of CPT codes are used on claims. This video offers a high-level overview of the three categories and explains their purposes. Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-credentialing-and-contracting Be su...
Plan Now! Budgeting for 2025 Financial Success in Your Practice
Переглядів 65Місяць тому
Prepare for 2025 financial success in your practice by budgeting effectively-learn how to analyze KPIs, forecast expenses, improve collections, and take advantage of year-end deals to set your practice up for a profitable new year! Unlock the secrets of healthcare credentialing and contracting with our comprehensive courses: navigatingthebusinessofmedicine.thinkific.com/courses/healthcare-crede...
How to Enroll in Medicare as a Provider Using PECOS
Переглядів 163Місяць тому
Enrolling as a provider with Medicare for the first time can be confusing, especially when using the PECOS portal. Although it's not difficult, it can cause anxiety due to the questions and information required. This video discusses the various types of provider enrollment, specifically when it's appropriate to use either the initial enrollment track or the reassignment track. Don't forget to l...
ICD-10 Code Changes: What to Expect on October 1, 2024
Переглядів 408Місяць тому
ICD-10 Code Changes: What to Expect on October 1, 2024
Applying for Your NPI Number: NPPES Portal Walkthough
Переглядів 204Місяць тому
Applying for Your NPI Number: NPPES Portal Walkthough
Get Started with CMS Identity & Access: Add a Group with Ease
Переглядів 962 місяці тому
Get Started with CMS Identity & Access: Add a Group with Ease
How to Prevent Credentialing Gaps for Your Providers
Переглядів 1202 місяці тому
How to Prevent Credentialing Gaps for Your Providers
How CMS 2025 Proposed Changes Will Impact Telehealth Providers
Переглядів 4182 місяці тому
How CMS 2025 Proposed Changes Will Impact Telehealth Providers
Crossing State Lines: Insurance Credentialing and Contracting Simplified
Переглядів 942 місяці тому
Crossing State Lines: Insurance Credentialing and Contracting Simplified
Boost Your Practice's Revenue: How Technology Can Improve Patient Collections
Переглядів 1422 місяці тому
Boost Your Practice's Revenue: How Technology Can Improve Patient Collections
Know How Credentialing and Contracting Can Directly Impact Prior Authorizations and Your Bottom Line
Переглядів 2162 місяці тому
Know How Credentialing and Contracting Can Directly Impact Prior Authorizations and Your Bottom Line
Prepare Your Practice: UHC Policy Changes for Therapy Services in 2024
Переглядів 2352 місяці тому
Prepare Your Practice: UHC Policy Changes for Therapy Services in 2024
Credentialing & Contracting for Nurse Practitioners and PAs: What You Need to Know
Переглядів 3732 місяці тому
Credentialing & Contracting for Nurse Practitioners and PAs: What You Need to Know
Protect Your Practice: The Importance of Knowing Your Payer Plans
Переглядів 1692 місяці тому
Protect Your Practice: The Importance of Knowing Your Payer Plans
Why Ignoring Payer Policies Could Be Costing You Big
Переглядів 1543 місяці тому
Why Ignoring Payer Policies Could Be Costing You Big
Top 6 Reasons for Claim Denials: Avoid Costly Mistakes in Your Practice
Переглядів 2263 місяці тому
Top 6 Reasons for Claim Denials: Avoid Costly Mistakes in Your Practice
Why Starting a Medical Practice is Harder Than You Think
Переглядів 1463 місяці тому
Why Starting a Medical Practice is Harder Than You Think
The Hidden Benefits of Regular Payer Contract Reviews
Переглядів 2783 місяці тому
The Hidden Benefits of Regular Payer Contract Reviews

КОМЕНТАРІ

  • @isabellalaird5596
    @isabellalaird5596 3 години тому

    Thank you for this video, very helpful. I am learning about primary and secondary insurance and have a question. Hoping to have a baby next year and opted for covering through my employer because it includes some IVF coverage. Now thinking of getting covered under my husband's insurance too as everything prebirth/birth related is 100% covered by them, whereas with my insurance we would still have to pay for 20% of the cost after deducible is met (80/20 rule). Am I right in thinking that if I get a secondary insurance through my husband's employer, they would pick up that remaining 20% of cost which would otherwise be my responsibility to cover? Thank you!

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 2 години тому

      Hi there and thanks for watching! How exciting. Yes, that is most likely what they would do/how it should work. I encourage you to call his insurance and ask about their secondary coverage with your benefits as primary specifically. That way you’ll know for sure. Good luck!!

  • @BetsyChyna
    @BetsyChyna День тому

    I enjoy your videos. They are truly helpful! I did SUBSCRIBE And hit the bell, and gave it a thumbs up. I just got my CLIA waiver my question to you I am a CNA in a home health aide. Can I do a EKG and use my CLIA waiver with that?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 День тому

      Thank you so much and I appreciate your support!! CLIA is only for laboratory tests. EKGs do not fall under that classification. Good luck!

  • @jayna640
    @jayna640 3 дні тому

    Can we create a virutal address in other state contract for dieticians ? Since they do tele health

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 День тому

      Hi and thank you for watching. All states and the insurances have different requirements so you would need to check the specific telehealth contracting guidelines and requirements. Good luck!

  • @SaddamHussain-wk1ji
    @SaddamHussain-wk1ji 3 дні тому

    ❤❤❤❤ Love from Pakistan

  • @kofitamakloe7136
    @kofitamakloe7136 5 днів тому

    Hello Jennifer Please can I get remote Health Insurance Adjuster jobs from TPA's.I am speaking from West Africa

  • @shaktiranjanpanigrahi301
    @shaktiranjanpanigrahi301 7 днів тому

    Is there any specific format in prior authorization number or it differs from insurance to insurance

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 7 днів тому

      @@shaktiranjanpanigrahi301 thank you for asking! It does vary based on the insurance, unfortunately. Great question and thank you for supporting my channel!

  • @rickyaclickpowr2187
    @rickyaclickpowr2187 10 днів тому

    would your course help someone who is switching career fields into the medical? Or is this only helpful for people already in credentialing?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 10 днів тому

      @@rickyaclickpowr2187 hi and thank you for asking. The video helps anyone not familiar with medical insurances and the credentialing process. Each section has a free overview of what is covered so viewers can see if they feel it would benefit them. Please take a look and good luck!

  • @amandabrown3776
    @amandabrown3776 12 днів тому

    Hello if i am preforming rapid testing in my office & mobile how do I put that on an application and do I need just a clia if i am not a doctors office or a hospital

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 12 днів тому

      @@amandabrown3776 hi there and good question! Yes, you would still need a CLIA waiver to be able to run rapid tests, and you would need to ask your local health department that issues the waivers. The CLIA waiver application may even have this option to select as a mobile company, so you would need to check it out. Thanks for watching!

  • @zahoorminhas
    @zahoorminhas 13 днів тому

    If a provider is already enrolled in a particular state and we need to enroll their group in that same state, and there's only one provider in the group, which application type should be used: 855I, 855B, or 855R? Please advise.

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 13 днів тому

      @@zahoorminhas you need to enroll the group using 855I and add the owner/provider on that application so they can be reassigned to that group. The 855R was discontinued but if you do it online via the pico website, it will fill it all out on the correct form for you.

    • @zahoorminhas
      @zahoorminhas 12 днів тому

      Thank you, @navigatingthebusinessofmed8251, for your assistance! Could you guide me on which documents typically need to be uploaded with a Medicare application for both a group and a provider?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 12 днів тому

      @ the application will walk you through what documents are needed, and who needs to sign them

    • @zahoorminhas
      @zahoorminhas 12 днів тому

      @@navigatingthebusinessofmed8251 thank you I'm asking for most mandatory documents because there are list of more then 15 documents.

  • @FedericoMortera
    @FedericoMortera 14 днів тому

    Pre auth is really a ton of works in healthcare industry.. lot of claims are being denied because of failure by members/providers to include medical history or medical records. It is time consuming once your claims are denied.. so better assure to attach all medical records while submitting claims.

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 14 днів тому

      Yes, it is very sad how many claim rejection and denials are a result of not obtaining authorizations. Medical records should not need to be sent with claims if the authorization is obtained prior to services rendered, and the medical records being sent with the claim will not replace the need for an authorization either. Clinics definitely need to do their due diligence and understand what plans need these. I appreciate your participation on my video and for watching!!

  • @modasalvador7435
    @modasalvador7435 16 днів тому

    Excellent video. Thanks for sharing

  • @modasalvador7435
    @modasalvador7435 16 днів тому

    Excellent video! Thanks for sharing

  • @modasalvador7435
    @modasalvador7435 16 днів тому

    Great video!

  • @margintrader26
    @margintrader26 16 днів тому

    Hi. Can u share what happens to the amount owed by the patient. Are they billed separately by the practice or if u have a billing company they send out a bill. Thanks.

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 16 днів тому

      @@margintrader26 Hi there. Whatever is left to patient responsibility (per the insurance adjudication) should be billed to the patient from the practice. The way that happens depends on your billing situation and if the billing company generates these for you, or if your clearinghouse does it, or if you need to do it. There are a few different possibilities, but you’ll also need to know who is responsible for following up on collecting from the patient if they don’t pay in a timely manner- the practice or the billing company. Again, could be multiple options depending on your situation. Good luck and thanks for watching!

  • @UshkaOfficial
    @UshkaOfficial 17 днів тому

    Amazing video thank you beautiful soul, I submitted ❤ and will be tapping into your course 🙌🏽☺️

  • @meadowrose100
    @meadowrose100 18 днів тому

    This is the first time I've seen your channel, with the exception of one other video watched today. I worked as a medical receptionist for 10-1/2 years and am hoping to get back into that field. I appreciate the videos you've put out so far. Thank you for sharing this content!

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 17 днів тому

      Thank you for watching and how exciting. I wish you luck getting back into the field. Here is the link to my blog posts on my website that may assist you with getting your feet wet again. integralclinicsolutions.com/blog/ I appreciate your support of my channel!

  • @modasalvador7435
    @modasalvador7435 18 днів тому

    Excellent Information, thank you for sharing.

  • @CarlynLei
    @CarlynLei 18 днів тому

    What about when they are not responding to potentially life threatening concerns in a timely manner?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 17 днів тому

      This is definitely a touch situation. I would suggest trying to contact their emergency contact and let them know you are having trouble contacting the patient and ask if they would contact them and have them call the office. You can also confirm the contact information you are using. Sending certified letters to the patient's home, or using electronic communication like a patient portal is another avenue to try. Although it can be life-threatening or very serious, you still have to be very careful in the information you divulge and to whom so you don't violate any laws. Great question and thanks so much for watching!

  • @julianwalton6519
    @julianwalton6519 19 днів тому

    Thanks for clarifying!!

  • @shanuRai435
    @shanuRai435 19 днів тому

    You are great ❤

  • @fyi6961
    @fyi6961 21 день тому

    I do not have access to buy these courses.. i am from out of usa country. If u add all courses in udemy it would help me . Thank you

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 17 днів тому

      Thank you for the suggestion. I will do some research into this platform to see if I can start offering them here as well. I appreciate you watching!

  • @fyi6961
    @fyi6961 21 день тому

    All courses is it available udemy??

  • @elizabethallemong1446
    @elizabethallemong1446 21 день тому

    Great!

  • @StandforAll
    @StandforAll 22 дні тому

    Thank you for this information

  • @nataliakleshchanka7679
    @nataliakleshchanka7679 25 днів тому

    Hello. You mentioned in a video that if a provider wants to start their own practice, they must disaffiliate themselves from current employer group in order to get credentialed with their own company. What if I still work at other company and want to do credentialing simultaneously for my new business, will it work? Or how to go about it? Thank you for your answer.

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 25 днів тому

      Hi there and thank you for watching! I apologize if I misspoke in that video. That is not true and you can be affiliated with as many groups as you’d like. When claims are processed and you’re the rendering provider on a claim, they insurance company checks to make sure your individual NPI (NPI 1) is affiliated with the billing group’s EIN and group NPI (NPI 2). That is how one provider can have multiple employers at once and not affect the other employers processing of claims. I hope this helps and good luck!!

  • @jessicagonzales3841
    @jessicagonzales3841 26 днів тому

    I went to look for a private practice and I found it, but the foundation from the billing dept not the stability I was looking for , so I took a just to leave front and back office to manage the billing Department. I saw ur videos and ur pace of explaining is perfect thank you

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 26 днів тому

      @@jessicagonzales3841 oh good for you! Sounds like you like challenges and they need people like you. Good luck and thank you for supporting my channel!

  • @MMukesh29
    @MMukesh29 Місяць тому

    Very knowledgeable video thanks for making

  • @ronicaleggett929
    @ronicaleggett929 Місяць тому

    also if the physician meets this qualification do the group practice automatically qualify as well?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      @@ronicaleggett929 hi there again. Group practices do not obtain licenses for practicing medicine. Those are only given to physicians as individuals. I hope this helps.

  • @ronicaleggett929
    @ronicaleggett929 Місяць тому

    Question? NP have been recognized as pcp in some states is this something they would qualify for as well?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      @@ronicaleggett929 hi and thank you for watching. This program is strictly for physicians only and no other providers, including NPs and PAs.

  • @SheerazAhmed-k1l
    @SheerazAhmed-k1l Місяць тому

    Hey Jennifer, thank you for creating this video. Very useful. Is there a good email which I can use to ask a couple of questions if you don’t mind? I’ve been searching the internet but I don’t know if I am headed in the right direction. Would be very helpful if I can get the information from someone like you. Thank you.

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      Hi there! Thank you for watching and you’re so welcome. I’m not super well-versed in DME but I’m happy to try. Jennifer@icsolns.net.

  • @DentalCareClarksville
    @DentalCareClarksville Місяць тому

    THANK YOU IVE BEEN "SELF / GOOGLE" LEARNING OVER THE PAST 10-YEARS. WISH I HAD YOUR VIDEOS BACK THEN. I LOVE LEARNING ABOUT INSURANCE AND CREDENTIALING IS VERY EYE OPENING AND SOMETHING MOST PPL DONT REALIZE WHAT I CALL THE SILENT OR BEHIND THE SCENE POSITION. IT'S BECOME A FULL TIME POSITION SINCE THE PRACTICE I WORK AT TAKES 40+ PLANS [DENTAL INSURANCE]. SO THANK YOU FOR THE REFRESHER.

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      I’m so happy to hear you find the information helpful! Good for you to be self-taught! It’s not easy. I appreciate you supporting my channel. Be well.

  • @janeth_6311
    @janeth_6311 Місяць тому

    Would love an example of checking a payer guidelines and procedures for one insurance company

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      Absolutely! I’m happy to do that for you. I will be recording videos this coming weekend for the next 3 weeks so keep your eye out! Thanks for watching and the request!!

  • @taylordmadeva3757
    @taylordmadeva3757 Місяць тому

    Nice breakdown- you learn something new everyday. I had no clue about the 3 different levels to cpt codes 🎉🎉

  • @zahoorminhas
    @zahoorminhas Місяць тому

    Please make videos on commercial payers as well.

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      @@zahoorminhas thank you for your input. Commercial payers are not this easy, but I do have many videos on credentialing and contracting that will discuss this at length. Please check those out. I have playlists to help you find them. Thank you!

  • @yosefnathan8648
    @yosefnathan8648 Місяць тому

    thanks for this great video!

  • @collinvanderpol5410
    @collinvanderpol5410 Місяць тому

    Thanks so much for this information. I am preparing to launch a campaign to renegotiate reimbursement rates for my mental health counseling contracts, so your information is most helpful. I'll definitely be looking into your other materials.

  • @ClairePodoll
    @ClairePodoll Місяць тому

    Does Cover My Meds let you do this?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      Cover My Meds does let you apply online and they interface with many EMR systems too. It’s a wonderful tool especially for making sure specific needed information is submitted for specific meds and payers. Thanks for watching!

    • @ClairePodoll
      @ClairePodoll Місяць тому

      @@navigatingthebusinessofmed8251 thank you so much! Do you know why for some medications on CMM information is auto populated and there seems to be extra support vs others are hard to track? Have you experienced this?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      I’m not exactly sure but I think it has something to do with their system and what they know is always required for specific meds and insurances. When they aren’t sure, they leave it blank. Just remember the basics that are always needed (tried and failed drugs, why they failed, how long they tried them for, if they’re on any contraindicated meds, etc.) and then you’ll also learn what drugs also need other information from doing it. I know that’s how I learned.

  • @FaizanNaeem250
    @FaizanNaeem250 Місяць тому

    Thank you for help full

  • @DonnaShepperson-u3f
    @DonnaShepperson-u3f Місяць тому

    I am a beginner Medicare, Biller, where would I enter the CMS form online I did enter them on the Change health care website,

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      Hi there. Thank you for watching. Are you asking about where to submit a claim? I’m not sure which form you’re referring to. Change Healthcare is a clearinghouse and should be able to submit the claim to Medicare for you because Medicare only accepts electronic claims. Most billing software uses a clearinghouse for this purpose. I hope this helps and if not, please provide more specifics on the CMS form in which you’re referring.

  • @kristendooher4779
    @kristendooher4779 Місяць тому

    Hi! Have some questions but can send a message on your website for some reason. Could you send you email address please?

  • @mpizzle13
    @mpizzle13 Місяць тому

    Awesome channel and vids! 🎉

  • @janeth_6311
    @janeth_6311 Місяць тому

    Jennifer, how can I contact you for help?

  • @FedericoMortera
    @FedericoMortera Місяць тому

    Thank you

  • @DanilaJimenez-z1y
    @DanilaJimenez-z1y Місяць тому

    super helpful thank you for the information. I'm an NP currently credentialed with Medicare at a non-profit women's clinic in Texas. I also have a license in New Mexico but we are not credentialed in New Mexico. Do we (practice & myself) have to apply for Medicare for the practice again in NM and then credential me or is there something else we can do since we are already credentialed with Medicare in Texas?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      Good morning and thank you for watching! Providers and groups (both) need to be enrolled with Medicare in each state they wish to practice and serve Medicare beneficiaries. This is the credentialing and contract process for Medicare. It can all be done through PECOS for groups/organizations and individual providers. Good luck!

    • @DanilaJimenez-z1y
      @DanilaJimenez-z1y Місяць тому

      @@navigatingthebusinessofmed8251 thank you so much!

  • @JoeydPimp-do7cv
    @JoeydPimp-do7cv Місяць тому

    Is there a specific website to find out what IPAs are available in southern Nevada?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      Not that I’m aware of honestly. I recommend using Google to see what you can find. It’s a good starting point. Also, if you have colleagues who work in other offices, you can ask them too. Good luck and I appreciate you watching!

  • @JoeydPimp-do7cv
    @JoeydPimp-do7cv Місяць тому

    I have a new family practice and am credentialed with about ten different insurances. How to I apply for the IPA program?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      Hi there and thank you for asking. You would have to find which IPAs are in your area and then find on their website where to enroll/apply. I am sorry I cannot be more specific, but every area is different and all IPAs require different processes. Good luck!

  • @janeth_6311
    @janeth_6311 Місяць тому

    Hi Jennifer, what if patient is PPO? They don’t usually need referral to see a specialist, they just call the specialist to schedule.

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      Yes, this is true. However, many offices still require peer-to-peer referrals from their PCP, just for their records. Many will not schedule until it is received. It is a practice-preference for PPO's, but no one should assume a patient does not need a referral if they have a PPO. So many things are changing. Thanks for watching and for commenting!

  • @zahoorminhas
    @zahoorminhas Місяць тому

    Hi Janifer, I hope this message finds you well. I am seeking your guidance regarding an issue with a Medicare surrogacy request I initiated for a group. I sent the provider a screenshot of the tracking number; however, she has been unable to locate it and, therefore, cannot approve the request. Despite reaching out to PECOS for assistance, the issue remains unresolved. I would greatly appreciate your advice on how to proceed, as this has become quite challenging. Thank you for your time and assistance. Wishing you a safe and pleasant weekend. Best regards, Zahoor Minhas

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      @@zahoorminhas hi and thank you for watching. I’m sorry to hear or these challenges. I would make sure the doctor is logging into the correct I&A portal, if you have not already. If so, perhaps ask the doctor to log-in to her I&A portal and search your name to add you as a surrogate. That would be her initiating it and you logging into yours to confirm the access. I have found this to be easier when I’ve been in the same situation. I also try to sit with the provider when they log-in, or do a zoom meeting with a screen share to assist where needed. I hope this helps and good luck!

    • @zahoorminhas
      @zahoorminhas Місяць тому

      @@navigatingthebusinessofmed8251 thank you so much Jennifer. This will help me.

  • @ericjohnson3269
    @ericjohnson3269 Місяць тому

    Is the initial price of $120 for the 99213 on the secondary claim reduced from the primary claim price of $180 because the primary contractual adjustment reduces the amount the practice is allowed to bill to the secondary?

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      Hi there and sorry for the delay. The original charge for 99213 was $180 and the primary insurance did a $60 adjustment leaving $120 difference. The primary insurance applied that entire balance to the patient. Since they have a secondary insurance that patient balance then gets forwarded to the secondary insurance to see if they will pay anything too. Unless the primary insurance is Medicare, then a billing company would actually have to forward the claim balance to the secondary insurance and include the primary insurance EOB so they can see how the primary insurance paid. If it is a Medicare primary most of the time they will forward the claim to the secondary insurance as a courtesy, but it is not the primary billing the secondary. Primary and second insurances don’t bill one another, they just process in sequence. So now the secondary looks at that balance on 99213 to see if the primary paid more than they would have or if there is still some room for them to also pay and they process from there. I hope that makes sense. Good luck and thank you for watching!!

  • @itsirkeel
    @itsirkeel Місяць тому

    I haven't even watched this yet, but I've missed checking in with you! I'm back doing billing and scheduling at a clinic again and need to get caught up on what all you've posted about in recent months. Thank you as always for your insights!!

    • @navigatingthebusinessofmed8251
      @navigatingthebusinessofmed8251 Місяць тому

      There you are! I was wondering where you have been. Congrats on the new job. I have lots of content for you to review and get ready for this new position. Thank you for your continued support! It is much appreciated. Enjoy the rest of your week.