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Introduction: In the dynamic landscape of healthcare, credentialing plays a pivotal role in ensuring the competence and reliability of healthcare practitioners and facilities. This blog delves into the intricacies of credentialing, its significance in the healthcare industry, and how partnering with StafGo Health can simplify and enhance this critical process. Understanding Credentialing: Credentialing is the process of verifying the qualifications, training, and experience of healthcare professionals to ensure they meet industry standards. It involves thorough scrutiny of educational background, licensure, certifications, and work history. Conclusion: In a healthcare environment where trust and efficiency are paramount, credentialing emerges as a cornerstone. StafGo Health’s tailored credentialing solutions empower healthcare practitioners to navigate this landscape with ease, ensuring a credible and reliable healthcare journey for both providers and patients. At StafGo Health, we go beyond industry norms to redefine excellence in healthcare financial management. Explore more about our credentialing services and join us in building a credible foundation for your practice and healthcare facility.

In response to the unprecedented challenges brought about by the COVID-19 pandemic, the U.S. Department of Health and Human Services swiftly implemented various administrative measures to promote and facilitate the adoption of telehealth services. While some of these changes are permanent, others are temporary and are in effect until December 31, 2024. Permanent Medicare Changes – Behavioral/Mental Health Services: FQHCs and RHCs can now serve as distant site providers. Medicare patients can receive telehealth services for behavioral/mental health care in their homes. No geographic restrictions for originating sites for behavioral/mental telehealth services. Behavioral/mental telehealth services can be delivered through audio-only communication platforms. REHs are eligible originating sites for telehealth. Temporary Medicare Changes through December 31, 2024 – Non-Behavioral/Mental Telehealth Services: FQHCs and RHCs can serve as distant site providers. Medicare patients can receive telehealth services in their homes. No geographic restrictions for originating sites. Some non-behavioral/mental telehealth services can be delivered using audio-only communication platforms. In-person visit not required within six months of an initial behavioral/mental telehealth service. Billing for Telehealth: Reimbursements for telehealth services continue to evolve. Resources on billing and reimbursement for Medicare, Medicaid, and private insurers are available. Medicaid reimbursement policies vary by state, and many commercial health plans have expanded coverage for telehealth services. Key Considerations for Providers – Telehealth Codes Covered by Medicare: Medicare added over one hundred CPT and HCPCS codes to the list of telehealth services. In the dynamic realm of healthcare, asynchronous telehealth, commonly known as “store and forward,” reshapes patient-provider dynamics by facilitating seamless sharing of crucial information such as lab results and images. For Medicaid, state-specific policies dictate billing procedures for asynchronous telehealth, ensuring providers align with regional guidelines. In Medicare, although federal limitations exist, specific tasks like virtual check-ins can be billed using designated codes. Notably, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can bill Medicare for telehealth services until December 31, 2024, encompassing a range of approved services. From home accessibility to distinct reimbursement rates for virtual communication services, this section sheds light on key billing nuances. For safety-net providers, StafGo Health offers tailored expertise, ensuring optimal billing processes and financial stability in the evolving telehealth landscape.  Coding Claims – Understanding Common Billing Mistakes: Understand the place of service (POS) codes affecting reimbursement. Common billing mistakes include incorrect billing codes, thorough post-visit documentation, patient consent, and billing for the actual time spent with the patient. State Medicaid Telehealth Coverage: Policies vary by state, with most states expanding Medicaid coverage for telehealth. Looking Ahead: The Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year 2024 Physician Fee Schedule Final Rule, extending telehealth flexibilities through December 31, 2024. Healthcare professionals are encouraged to stay informed about ongoing changes and updates in telehealth policies.  How StafGo Health Can Help: Amidst these evolving telehealth policies, StafGo Health stands as a trusted partner in healthcare financial management. Our highly qualified team, boasting decades of experience, is equipped to navigate the complexities of Healthcare billing and reimbursement. We understand the nuances of Healthcare billing and can ensure accurate and efficient billing processes. With a proven track record, StafGo Health is committed to empowering healthcare providers, enhancing operational efficiency, and securing financial stability. For more detailed information, resources, and personalized assistance, reach out to StafGo Health (Email: Support@StafGo.com). As the healthcare landscape continues to evolve, having a reliable partner in billing and credentialing solutions is paramount. Let us be your ally in shaping a successful and financially secure future for your practice.   Reference: Telehealth policy changes after the COVID-19 public health emergency | Telehealth.HHS.gov

In the face of formidable challenges, healthcare organizations find themselves at a crossroads, grappling with issues such as wage inflation, rising costs, and the pervasive uncertainties brought on by the pandemic. This critical juncture has thrust unprecedented pressure on financial stability, particularly as unresolved claims denials result in an annual average loss of $5 million for hospitals—equivalent to 5 percent of net patient revenue. Understanding the Urgency: Rising Denial Rates At StafGo Health, we recognize the urgency of this situation. Denial rates have surged, escalating by over 20 percent in the last five years, with the average denial rate now surpassing 10 percent. A recent Medical Group Management Association (MGMA) Stat poll has shed light on the challenges faced by practices, reporting a significant 17 percent increase in denials. Shockingly, industry averages reveal that nearly 20 percent of all claims face denial, and up to 60 percent of returned claims are left unresubmitted. The financial impact escalates further, with reworking or appealing denials costing an average of $25 per claim for practices and an astonishing $181 per claim for hospitals. Amidst these challenges, StafGo presents a solution—a beacon of hope in the storm. Our expertise in healthcare financial management positions us as a strategic partner, equipped to assist organizations in navigating these turbulent waters. We firmly believe that denial doesn’t have to spell defeat; it’s an opportunity for recovery. With the right approach, up to two-thirds of rejected claims can be reclaimed. Strategic Solutions for Financial Recovery Our strategic solutions are meticulously crafted to align with payer requirements, ensuring an optimized recovery process. StafGo stands ready to assist healthcare organizations in unlocking financial stability, optimizing recovery, and securing a robust financial future. StafGo Health: Navigating Financial Storms, Ensuring Stability In conclusion, the healthcare landscape is evolving, presenting challenges that demand innovative solutions. StafGo Health emerges as a partner dedicated to addressing the financial pressures faced by healthcare organizations. Join us in the pursuit of financial stability, strategic recovery, and a resilient future. References: Claims Denials: A Step-by-Step Approach to Resolution By Leigh Poland, RHIA, CCS, and Srivalli Harihara, CPC, PGPAIML “A Proactive Outpatient Remittance Model Improves the Hospital’s Bottom Line and Positively Impacts the Patient Experience.” Becker’s Hospital Review, August 12, 2021. Gooch, Kelly. “4 Ways Healthcare Organizations Can Reduce Claim Denials.” Becker’s Hospital Review, July 18, 2017.

Introduction: In the complex landscape of healthcare, effective management of the revenue cycle is paramount for physician groups to thrive financially. Consistent cash flow not only solidifies the foundation of a practice but also empowers it to deliver superior patient care, innovate, and expand. This blog explores essential strategies to seal revenue leakage gaps in medical billing—a common challenge that, if not addressed, can significantly undermine a practice’s financial health. Understanding Revenue Leakage in Healthcare: Revenue leakage occurs when payments for services rendered by healthcare providers are not captured. This can result from unclaimed accounts receivable, coding errors, or missed deadlines for claim submissions. For instance, if a claim is not filed promptly post-treatment, the opportunity to receive payment may be permanently lost. The repercussions of such revenue leaks are profound, impacting the financial stability and growth potential of healthcare practices. The Impact of Revenue Leakage: The financial implications of revenue leakage are substantial, potentially costing healthcare providers 15-20% of their possible revenue as indicated by studies in the Journal of the American Medical Association. This loss directly affects the practice’s ability to fund crucial operational needs such as technology upgrades and staff development. Moreover, the strain of managing financial inconsistencies can deteriorate patient trust and satisfaction, which are critical to the success of any healthcare provider. Strategies to Seal Revenue Leakage Gaps: Conclusion: Addressing revenue leakage is crucial for sustaining the financial health and operational efficiency of healthcare practices. At StafGo Health, we understand the intricacies of healthcare billing and offer tailored solutions that encompass optimized processes, ongoing staff training, advanced technological integration, and strategic management. Partnering with us empowers physician groups to secure their financial operations, enhance revenue recovery, and elevate overall practice performance. Discover how our expert RCM services can transform your practice by contacting us today. Let’s embark on a journey toward financial excellence together. Interested in learning more about how to secure your practice’s financial health? Contact StafGo Health today and explore solutions tailored to your unique needs.

Introduction: In the ever-evolving landscape of healthcare, efficient billing processes play a pivotal role in the success of dental and medical practices. StafGo Health is at the forefront, providing comprehensive solutions to navigate the complexities of billing in these crucial domains. Understanding the Landscape: Billing for dental and medical services involves intricate procedures, from claim submissions to payment processing. The intricacies of coding, compliance, and credentialing require a dedicated approach to ensure seamless operations and optimal financial health. End-to-End Solutions: At StafGo Health, we offer end-to-end solutions for dental and medical billing. Our specialized team is equipped to handle the entire billing lifecycle, reducing claim denials and maximizing reimbursements. We recognize the unique needs of each practice, whether a small clinic or a multi-location facility. The Role of Coding: Accurate coding is fundamental to successful billing. StafGo Health boasts a team of skilled coding professionals who stay abreast of the latest coding changes. This ensures that our clients receive optimal reimbursements while maintaining compliance with industry standards. Credentialing Excellence: Enhancing the credibility of a practice is a key focus at StafGo Health. Our meticulous credentialing services cover provider enrolment, verification, application processing, and ongoing maintenance. This commitment to excellence ensures continuous compliance and seamless operations. Optimizing Billing Processes: Our comprehensive billing solutions go beyond the basics. StafGo Health specializes in insurance verification, minimizing claim denials, and streamlining the billing process. We provide transparent billing statements, contributing to enhanced patient satisfaction and improved financial interactions. Financial Reporting and Analysis: Real-time financial insights are essential for informed decision-making. StafGo Health offers robust financial reporting and analysis services, allowing practices to track key performance indicators, identify trends, and optimize their financial health. Tailored Solutions for Success: Recognizing the uniqueness of each dental and medical practice, StafGo Health tailors solutions to specific needs. Whether a solo practitioner or part of a multi-specialty clinic, our services adapt to ensure success in the ever-changing healthcare landscape. The StafGo Health Advantage: Partnering with StafGo Health means choosing a reliable ally committed to precision, efficiency, and personalized service. Our decades of experience in full Revenue Cycle Management (RCM) make us leaders in the field, providing unmatched insights and expertise. Conclusion: In the dynamic realm of dental and medical billing, StafGo Health stands as a beacon of excellence. Our unwavering commitment to optimizing billing processes, ensuring compliance, and enhancing financial health makes us the partner of choice for practices seeking success in the modern healthcare landscape. Experience the StafGo Health advantage and elevate your practice to new heights.

In response to the recent cybersecurity incident at Change Healthcare, a subsidiary of UnitedHealth Group, the Centers for Medicare & Medicaid Services (CMS) has taken significant steps to mitigate the impact on Medicaid providers and ensure continued access to healthcare coverage. CMS has introduced new flexibilities aimed at assisting state Medicaid agencies in providing much-needed relief to affected providers. These flexibilities include enabling states to initiate interim payments to providers affected by the cybersecurity incident. To facilitate this, CMS is encouraging states to submit Medicaid state plan amendments (SPAs) to authorize certain interim payments for services rendered by providers who are unable to submit claims. Additionally, CMS has issued guidance to support states in implementing these flexibilities, allowing them to make retroactive interim payments to affected providers and draw Federal Financial Participation (FFP) once the appropriate Medicaid SPA is submitted, subject to specific conditions outlined in the guidance. Furthermore, CMS emphasizes the importance of safeguarding critical links to healthcare coverage and remains actively engaged with state Medicaid agencies, health plans, providers, suppliers, and other stakeholders to address concerns and ensure continued access to care. In addition to these flexibilities, CMS has extended the data submission deadline and reopened the 2023 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances (EUC) Exception Application to provide relief to clinicians impacted by the cybersecurity incident. This application will remain open for the remainder of the data submission period, closing on April 15, 2024.   For more details, please refer to the following links: https://www.cms.gov/newsroom/press-releases/statement-change-healthcare-non-enforcement-medicaid-informational-bulletin https://www.medicaid.gov/federal-policy-guidance/downloads/cib031524.pdf