Mpowermed™ Inc. Drives “Monumental” Shift in Insurance Practices
PR Web |
Once considered back-room services, medical management and billing organizations that want to flourish in this highly competitive industry need to become strategic partners to providers. They also need to become advocates for patients and act as "friendly" problem solvers for insurance companies, says
Of the many success stories Ms. Winington has achieved at Mpowermed, she spoke about one striking accomplishment: how the company made a system-wide change to processing claims at a major third-party medical claims processor, or Utilization Management Program. The company worked nearly a year to get a large insurance provider's Utilization Management Program to change how they handled certain coding and approvals for procedures and treatments. This system-wide change began when one patient needed treatment and was facing thousands of dollars in out-of-pocket medical bills. Insurance companies use diagnosis and coding procedure "worksheets" as part of the approval process. "In this worksheet there was no accounting for 'brain/bone metastases' and the associated treatment and technique to be performed," says Ms. Winington.
Convincing a major Utilization Management Program, which processes claims for major insurance companies such as
"We had to work with senior executives, at the Utilization Management Program, including the chief medical officer, the CEO and the president," Ms. Winington says. "Revising a company-wide process was a monumental shift," she adds, "While I don't believe that we are the only medical management company experiencing this, I do believe we're one of few that will go to these lengths."
Providers already stretched for time will have to be more meticulous in keeping records, as well as managing their practices. These changes are creating more opportunities for medical management companies. There's been a steady increase of competition, given the opportunities and the low barriers to entry, observers say. But not all medical management and billing companies are the same: Mpowermed prides itself on having experienced business management experts that go the extra mile.
With the new medical billing codes and regulations barreling down on providers, Ms. Winington is confident the company's collective years of medical management experience can help providers successfully navigate the industry-wide changes, with little to no business disruptions. In addition, Mpowermed also offers qualifying providers a FREE Electronic Health Records!
Mpowermed, inc., established in 1998 and based in
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