Author: Scott Rupp

How To Automate Your Medical Claims Audit Process

Automation has become increasingly popular in business over the past few years. By automating business processes, you can reduce errors, save time, and save your business a lot of money.

It can seem like a daunting prospect, though. How on earth do you go about automating a complex process? Especially one as complex as a medical claims audit?

By breaking your process down and working with experts in the field, you’ll find that your processes can be automated, and you can start enjoying the benefits.

Work with experts in your field

When looking for your claims audit software, it’s important that you work with a provider who understands your industry and who has worked on automation projects in your industry before.

If your software provider is experienced in your field, they will be able to give you great insight on how to go about the automation process, as well as having experience of where these projects have been successful (or not so successful) for other companies in your industry.

They should also be able to make suggestions on how to improve your business processes, as a lot of automation is around making the processes themselves as streamlined as possible, rather than simply just asking a computer to do the process that is already in place.

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2021 Medicare Advantage Plan Intelligence: An Early Look

By Rachele Elasky, product manager, and Sarah Chien, analytics solutions manager, Carrot Health.

The Centers for Medicare and Medicaid Services (CMS) in recent months predicted both lower premiums and richer benefits for Medicare Advantage (MA) plans in 2021. Specifically, CMS anticipated a decrease in average premiums of more than 34% from 2017 levels while plan choice, benefits, and enrollment increased—making the average monthly premium the lowest in 14 years.

But while CMS accurately depicted the indisputable trend of moving toward lower costs and higher value in MA offerings, it did not tell the whole story. To do that, we consolidated and reported on all Medicare Advantage and Prescription Drug Plan (PDP) benefit data nationwide released by CMS. This provides a much clearer picture on how these trends impact individual members vs. across member populations.

Following are the highlights of that analysis.

More Plans Offered Than Ever Before

There will be a 13% increase over 2020 in the number of MA plans available nationwide for individual enrollment in 2021. At 3,545, this is the most plans ever offered and includes 665 new plans—a nearly 4% increase from the 642 new plans offered in 2020.

While MA enrollment is rapidly increasing, the competition is growing even faster.  In 2021, there will be 21.5 MA plans in the country for every 100,000 beneficiaries. That compares to 16.8 plans per 100,000 in 2018, which is an increase of more than 53% in just four years.

This growth is not uniform across the country, however. Densely populated markets in the Northeast such as metropolitan geographies typically have the most plans to choose from although enrollment growth rates have been higher in more rural areas of the country in recent years.

New Plans, More Value

New MA plans being introduced into the market for 2021 generally offer more value than existing plans through lower premiums and richer benefits. Among new plans, premiums are one-fifth of those for existing plans ($9 vs. $42), anticipated out-of-pocket costs are lower, and nearly every supplement benefit is offered at a higher rate.

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5 Easy Methods To Grow Your Healthcare Business

It’s no secret that healthcare businesses face some unique challenges, especially in this unstable economy. And with so many regulations and rules on the books, it can be challenging to make changes that result in long-term success. That’s why these five proven tips can help you make big changes that can have a real impact:

Form a strong base on social media

We often feel that Facebook, YouTube, etc. These social sites are just for the youths, and that nothing significant can occur here. But let me tell you are gone are the days when these statements were considered trustworthy, how nearly everybody is socially very successfully promoting their businesses. Social media has a great reach and network.

You can share any sensitive information about any patients online. But you can use it carefully and follow it up on Facebook or any other platform. You can also write a blog about common health issues and tips to cure them so that more and more people come to know about you. This way, you can uplift the graph of your patients. Continue Reading

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5 Proven Tips For Choosing A Degree In Healthcare

There are many things you must consider first. First and foremost, what is your major? Some people go with a Bachelor’s in healthcare, while others prefer to take classes towards a Master’s in healthcare. If you choose a Bachelor’s in healthcare, you may want to take classes such as psychology, human services, and nutrition. These courses can help you get into med school and keep you on top of your career. These programs may not have much practical experience in any specific field. Still, they do provide ample classroom instruction and can make you valuable to med school.

Before pursuing your medical career, there are certain factors you must keep in mind. These factors are going to help you make the right choice for you.

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Most Common Causes of Muscle Loss In Middle-Aged Men

For those perhaps not familiar with sarcopenia, it is a term that was coined by the Greek university professor of nutrition and medicine at Tufts University’s USDA Human Nutrition Research Center Irwin H. Rosenberg in 1988. And it is the adjoining of two Greek words, “sarx,” meaning flesh, and “penia,” which means loss. Starting in their 40s, most men and women will lose about 3 percent of muscle strength every year. This same decline in muscle strength, for some individuals, can lead to severe muscle degeneration and exceedingly low bone density, both of which are the hallmarks of sarcopenia.

While this age-related health problem can impact men and women alike, it is far more common among men. For reference, sarcopenia affects the lives of 19.2 percent of older men and 8.6 percent of older women, according to a study published by the National Institutes of Health.

Aging and Body Changes: Factors That Negatively Affect Muscle Mass in Middle-Aged Men

For the most part, a decline in hormone production explains why some men begin to lose muscle mass in their 40s, namely testosterone and human growth hormones. To further put this into context, let’s take a look at what happens to HGH levels as men get older. After age 30, the pituitary gland, one of many hormone-secreting glands in the body’s endocrine system, gradually secretes fewer human growth hormones. By age 40, the same bean-shaped gland, located at the lower region of the brain, only secretes about 200 mg of growth hormones per day compared to 500 mg per day at age 20. And by age 60, the drop-off in production is even more substantial in that the pituitary gland only secretes around 25 mg of HGH per day.

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6 Benefits of Hiring An SEO Expert In Healthcare Marketing 

Every business today knows the usefulness of having an active online presence to reach out to people. Marketing your practice or hospital means learning some complex terms and jargons in order to increase your search engine ranking. One of the first steps in boosting your website is optimizing an SEO agency for your healthcare website. 

Search engine optimization(SEO) means optimizing your website for the top search engines like Google and Bing. If you’re a dentist, you want the term “dentist near me” to bring your name up first. SEO is a compelling marketing tactic that can bring more qualified clients and patients to your medical practice. There are a lot of organizations offering SEO services to their clients based on their requirement. If you are new to the online realm and looking for a good web host provider. Websites like MangoMatter UK can help you pick the best web host provider according to your needs. Here are a few advantages that can be obtained by contracting the service of an SEO company or agency:

(6 Benefits of Hiring an SEO Expert in Healthcare Marketing, Credit: Pexel)

Increased visibility 

The primary reason a practice or hospital would use targeted healthcare SEO is to boost your website ranking on search engines. When potential clients or visitors search a particular keyword in search engines, if your website appears on top. You are likely to drive more traffic to your site and gain possible conversions. Searchers trust Google because it is the world’s leading search engine. And as a byproduct of that, they trust your practice when it appears at the top.

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Telehealth Proving To Be A Game-Changer During COVID-19

By Piyush Jain, founder and CEO, Simpalm.

Piyush Jain

Telehealth is the delivery of health education, health information services, and healthcare services using remote technologies like telecommunication and digital communication. It has long been around in the healthcare industry.

However, previously providers hesitated in embracing the potential of it because of the low revenue and costly infrastructure needed to set it up. Nonetheless, the COVID-19 pandemic completely transformed that scenario. Caregivers were compelled to adopt telehealth technologies for their own safety and follow social distancing norms.

Since the pandemic, telehealth services have gained tremendous momentum, particularly for the following reasons:

However, one must not confuse telehealth with a phone consultation. Telehealth is different as it incorporates many facilities for better delivery of healthcare to patients remotely, like,

Telehealth Modalities

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How Emerging Tech Will Impact The Healthcare Industry In 2021

Person Showing Magnifying Eyeglasses

By Adrian Johansen, freelance writer; @AdrianJohanse18.

“We believe consumer health technologies — apps, wearables, self-diagnosis tools — have the potential to strengthen the patient-physician connection and improve health outcomes,” said Dr. Glen Stream, Chairman of Family Medicine for America’s Health. It is this sentiment that will perhaps shape tech adoption in healthcare through 2021 and beyond, the keywords being accessibility and connectivity.

As the world reels from the effects of the COVID-19 pandemic, we look to medical advances that will shape the future of healthcare. Emergent healthcare tech must connect a socially-distanced world to offer greater healthcare solutions for a greater portion of the population. Through cloud data and artificial intelligence, these solutions are increasingly possible.

Consumer-focused, accessible technologies are transforming the healthcare industry, with impacts likely to be felt as we move into 2021. COVID-19 quickened this transformation, and now healthcare professionals and patients alike look to benefit from the connective devices and technologies of the future.

Entering the Matrix through Digital Healthcare

A few years ago it might have seemed absurd to entertain the notion of increasingly virtual healthcare. The coronavirus changed that. Now, state and local governments are breaking down barriers to allow for novel, digital treatment plans that can take place over a smartphone video call. This has been a groundbreaking shift in terms of healthcare accessibility.

Telehealth innovations are emerging that offer everything from cardiology to infectious disease treatments all through virtual platforms. Care providers are even cutting costs through tele-paramedicine, which allows emergency patients to speak with specialists before they even make it on an ambulance. In turn, unnecessary transportation can be avoided for cost savings for patients and providers alike.

Throughout 2021, we will likely see vertical growth of telemedicine as more and better data analytics, paired with smart software, build a matrix for remote healthcare possibilities.

Alexa, Track My Medical Records

The digitization of healthcare is trending into smart home systems. These hubs of living room convenience are making waves in at-home healthcare, offering care coordination for chronic disease management. In the landscape of COVID-19 concerns, such innovations offer the kind of safety and accessibility needed for vulnerable patients.

Programs designed with Amazon’s Alexa in mind have made possible the tracking of diabetic information, blood pressure, medication compliance, and more for the benefit of at-home users. The online nature of these devices offers physicians the ability to experience real-time metric tracking alongside wearables to better monitor patient health.

Meanwhile, the improvements made in voice recognition through smart home devices have streamlined everything from the ability for users to get quick insurance quotes to assisting medical coders in medical transcription practices.

With the need for safe, at-home care, smart home systems and voice recognition tech will be a stable of healthcare solutions for the future.

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4 Reasons Why You Should Invest In Your Telemedicine Services

person wearing lavatory gown with green stethoscope on neck using phone while standing

Many healthcare professionals are now providing telemedicine calls and video conferences as an option to their patients due to the COVID-19 pandemic. Although this is a wonderful tool for both patients and doctors, many people have not taken full advantage of the easy access they now have to their doctors. In addition, doctors have not yet understood the full scope of benefits that this form of communication has to offer.

Unfortunately, many hospitals are fearful about the HIPAA compliance, technological advancements, and legal implications of using this form of care. There are expert lawyers that are trained to handle CA telemedicine violations if a client believes that their privacy was violated. After the legal requirements are adhered to, there are a few reasons why telemedicine will improve your pipeline of business.

1. Patient Loyalty

Often, patients visit a doctor once every few years, with little to no contact in between consultations. When you only see your doctor every few years, it is difficult to develop a trusted relationship. Without a relationship, you are likely to prospect other doctors that have more flexible schedules or cheaper services. When you provide telemedicine capabilities to your client, you can begin a loyal relationship. This relationship will help the customer develop trust for your services and loyalty to your organization.

2. Cost Savings

When you use telemedicine, both the doctor and the client save money. For patients, it is expensive to visit the physician every time you have a question or concern. For hospitals and offices, it is cumbersome to reapply hygiene essentials and conduct routine examinations for each and every patient. By having certain consultations that can be completed over video conferencing, both parties will save time and money.

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Top Tech Resources For Improved Physical and Mental Health In 2021

Living through a pandemic these past few months has been grueling on the mind and body. Whether you contracted the coronavirus, lost a loved one, or had to deal with the stresses associated with changes to everyday life, chances are you’re exhausted. Despite the circulation of vaccines, the journey towards normalcy is an uphill battle. Ultimately, if you’re going to have the physical and mental strength to weather the storm, you’ll need to prioritize your health. 

Trouble Making Change

Most people are aware of the importance of good health. Some even make steps towards improvement. Unfortunately, learning new concepts and applying them to your life isn’t as easy as it sounds. From a lack of motivation to setting unrealistic goals, several factors impede progress. Consequently, you revert to old ways and fail to meet your mark. 

Technology Can Help

The integration of technology in the health and wellness industries has resulted in the development of innovative platforms. When used effectively, these resources help users reduce roadblocks and distractions that prevent them from being their best selves. From goal setting and lifestyle management applications to virtual healthcare services and online support groups, here are some of the most popular resources to adapt. 

Fitness Trackers

If the goal is to improve your diet and exercise habits, fitness trackers can help you stay on the right track. Users can set nutrition and fitness goals and monitor their daily progress. Using this platform provides accountability, motivation, and support as you strive to reach your goals. With daily notifications, real-time monitoring, and regular progress reports, users can access data that can help them improve their health. 

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