Commercial Health Insurance FAQs Q: What is a Managed Care Organization? A: Managed care health plans are ones in which patients have covered benefits with certain doctors and hospitals. Health care providers and medical facilities enter into contracts to provide care for members at reduced costs. These contracted providers make up the plans’ networks. The…
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Download Reference Tool
This helpful tool can provide all the information your clinic needs to locate the websites and stay up to date on Medical Review Policies, Payer Updates, Eligibility checks and verification of benefits. Simply download, customize the fields with all the necessary data and print a hard copy for your front desk and/or billing team.
Carrier and Verification Reference Tool
Medical Review Policy Matters Make no mistake, the Medical Review Policy (MRP) does matter, and it plays a key role in determining the care that is reimbursable by a payer. The MRP is an administrative and educational tool designed to help providers, physicians, and suppliers submit correct claims for payment. Medical Review Policies outline how…
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All Blues Are Not the Same A very popular plan that most clinics will come across is the Blue Cross Blue Shield (BCBS) Plan. Each clinic needs to familiarize themselves with both the local and out of state plans that may be common in your area. All BLUES are NOT the same; there are Blue…
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Healthcare has evolved over the last few decades into a much more tightly regulated industry. Whether your office participates with insurance carriers or simply bills insurance as a courtesy after the patient has paid, it is important to understand how managed care affects the clinic and your patients. View this Rapid Tutorial titled Managed Care…
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Identifying a Managed Care Patient Healthcare has evolved over the last few decades into a much more tightly regulated industry. Whether your office participates with insurance carriers or simply bills insurance as a courtesy after the patient has paid, it is important to understand how managed care affects you and your patients. Managed care health…
Oops, your level of membership doesn’t include access to these full training courses. Please reach out to the HelpDesk to learn more about accessing these trainings and resources.
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