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Did you know that 145.6 million patients go to hospital emergency rooms all over the United States every single year? On top of that whopping statistic, there are general admissions, direct-to-care patients, and other admissions that don’t go through the ER. Each hospital carefully tracks and monitors each one of these patients, and one of … Read more

According to a 2020 study by InstaMed, medical bills are confusing to more than 70% of patients. On top of that, 80% of patients were surprised by a medical statement they received.  These numbers are staggering. Patients should know how much money they will owe for a doctor’s visit or medical procedure beforehand. One way patients can understand their financial … Read more

Are you struggling to understand your medical bill? Bills from hospital visits and treatments can be very complex. Every test, procedure, and treatment need to be clearly marked on the bill in a way that can be easily understood. This is why the healthcare industry uses standardized codes. But to the uninitiated, these codes can … Read more

Medicare severity-diagnosis-related groups, abbreviated as MS-DRGs, are categories of inpatient hospital stays. The Medicare system uses them to determine reimbursements for hospitals, skilled nursing facilities, and hospices. A hospital stay can range from one day to 100 days. The most expensive MS-DRGs have the longest average stays. These expensive hospital services may include open-heart surgery or lung … Read more

If you’ve never heard of ancillary services before, you’re in the right place. Learn what these are and why you should care today.

In recent years, healthcare delivery systems have been focused on providing patients as much freedom of choice when it comes to their personal healthcare. These common types also allow for efficiency, lowered costs, and ease of use. 1. Telemedicine Although telemedicine existed before the COVID-19 pandemic, it has seen monumental growth in recent years. A … Read more

In healthcare, APC stands for either advanced practice clinician or ambulatory payment classification. What is an Advanced Practice Clinician (APC)? Advanced practice clinicians are clinicians who are not doctors, but provide a role that is very similar to a doctor. Advanced practice clinicians typically refers to advanced practice registered nurses (APRNs) and to physician assistants (PAs). An APC is a healthcare … Read more

PPS stands for “prospective payment system” and is a classification system used by the Centers for Medicare and Medicaid Services (CMS). CMS is the government agency responsible for running both Medicare and Medicaid. A PPS is a method of reimbursement in which CMS payments to healthcare providers are made using a predetermined, fixed amount based on … Read more

To know what an ambulatory care pharmacy is, we first need to know what ambulatory care is. Ambulatory care or ambulatory treatment is another word for any outpatient care. This is any medical care that happens outside of a hospital. According to the Agency for Healthcare Research and Quality, “these settings include medical offices and clinics, … Read more

The ultimate guide to navigating what can be a confusing topic in healthcare. Although it can sound daunting, almost everyone will have to work with a third-party payer when navigating healthcare costs. You’ve likely dealt with one without even realizing a third-party payment (TPP) is what it’s called. Third-Party Payment Definition In the healthcare world, … Read more