NCQA Releases Top 984 Health Insurance Plan Rankings
Which TJC Accreditation Program is Right for Your Organization?
BHM Healthcare Solutions Spotlight – Healthcare Financial Analysis
Do You Know the ACA? A Quiz to Test Your Knowledge
How much do you know about the Affordable Care Act? Have you read all 900 pages? Do you know what to expect in the years to come? Below is a quiz to test your knowledge to see if you are an ACA expert. Do You Know the ACA? Do You Know the ACA? For 2010 […]
Protecting Health Records: The Physician Isn’t the Enemy
Protecting Health Records: The Physician Isn’t the Enemy
How Do You Reduce Medical Denials?
Now that we’ve discussed how you can reduce medical denials, follow our Insights page for more of our valuable content on health policy and upcoming compliance regulations
The Value of CARF Accreditation
Medical Necessity and the Role of Physician Services
Medical necessity is a medical claims determination which encompasses outcomes which are justified as reasonable, necessary, and/or appropriate based on evidence-based clinical standards of care. Evidence-based medicine (EBM) aims to apply the best available evidence to clinical decision making. It seeks to assess both the of risks and benefits of treatments and diagnostic tests and […]
What are PA Services: Understanding physician advisor services?
What Are PA Services? Exactly what are PA services? Physician Advisors serve in multiple capacities throughout healthcare and managed care organizations. They conduct medical necessity reviews, may be called upon to assist in organizational audits, and in some cases are essential in identifying and reversing inappropriate medical necessity denials and a variety of appeal levels. […]
BHM Healthcare Solutions Launches Enhanced PRS Portal
BHM Healthcare Solutions, a healthcare consulting firm first introduced the PRS portal for providing physician peer reviews in August 2011. Since then, BHMs IT Department has made continual improvements to the PRS Portal to increase automation, efficiency, and responsiveness.