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Tel: (+1) 512 800 6431
Fax: (+1) 512 367 5743

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    Q) What is Medical Billing?

    A) Medical Billing is the process of submitting health insurance claims on behalf of the patient to various health insurance payers for the purpose of acquiring payment for services rendered in a medical facility.

    Q) What is RCM in healthcare?

    The Revenue Cycle Management includes all the administrative and clinical functions that contribute to the capture, management and collection of patient service revenue, according to the Healthcare Financial Management Association (HFMA). Revenue cycle management (RCM) is the financial process, utilizing medical billing software that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance.

    Q) What does HIPAA compliant mean?

    The Health Insurance Portability and Accountability Act (HIPAA) sets the standard for sensitive patient data protection. Companies that deal with protected health information (PHI) must have physical, network, and process security measures in place and follow them to ensure HIPAA Compliance. Covered entities (anyone providing treatment, payment, and operations in healthcare) and business associates (anyone who has access to patient information and provides support in treatment, payment, or operations) must meet HIPAA Compliance. Other entities, such as subcontractors and any other related business associates must also be in compliance.

    Q) Define MACRA?

    The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a bipartisan legislation signed into law on April 16, 2015.
    MACRA created the Quality Payment Program that:

    • MACRA also required us to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019.
    • Repeals the Sustainable Growth Rate.
    • Changes the way that Medicare rewards clinicians for value over volume.
    • Streamlines multiple quality programs under the new Merit Based Incentive Payments System (MIPS).
    • Gives bonus payments for participation in eligible alternative payment models (APMs).

    Q) What is MIPS? How it works?

    The Merit-Based Incentive Payment System (MIPS) is the program that will determine Medicare payment adjustments. Using a composite performance score, eligible clinicians (ECs) may receive a payment bonus, a payment penalty, or no payment adjustment.

    MIPS streamlines 3 currently independent programs to work as one:

    • Electronic Health Record Incentive Program/Meaningful Use (MU)
    • Physician Quality Reporting System (PQRS)
    • Value-Based Modifier (VBM)

    MIPS also adds a fourth component, Improvement Activities (IA), to promote ongoing improvement and innovation. This new program will ease clinician burden and allow clinicians to choose the activities and measures that are most meaningful to their practice to demonstrate performance.

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