A Medical billing audit is often thought of as a defensive measure. A government or private payor has denied or pended a series of claims. Now they want copies of…
Category: Assessment & Benchmarks
Physician Revenue Cycle Key Indicators of Best Practices
Physician revenue cycle operations continue to transform fundamental aspects of modern medical practice. The current unsustainable system drafts individual elements of the revenue cycle in search of success, often ignoring…
What is Value Based Reimbursement Looking Like in 2019?
Change is a constant in the healthcare industry, and for all healthcare providers submitting claims to Medicare it’s important to carefully review your processes based on what’s to come with…
Hospital Revenue Cycle Best Practices for Profitability
Hospital revenue cycle management inefficiencies cost providers millions each year in lost income, and this is a single provider (and on average) estimate. When you examine hospitals collectively, this figure…
Healthcare Revenue Cycle Management Automation
Healthcare revenue cycle management needs to be automated! Revving up the revenue cycle or optimizing cash flow by cutting down on the time between patient-related services and monetary collections is…
Value Based Reimbursement – Are you prepared?
Is value based reimbursement replacing Fee-for-Service (FFS)? FFS has been the standard in patient care for decades. The focus on revenue cycle best practices was and will continue to be…
MIPS, are you ready? The Merit-based Incentive Payment System.
As mentioned in a previous blog, MACRA combines parts of the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VBM), and the Medicare Electronic Health Record (EHR) incentive program into…
How to Start a Medical Practice – it’s a business, too!
How to start a medical practice . . . . When I was being interviewed for an article about billing and accounts receivable recently for Dermatology World magazine, I was…
What is MACRA?
The roll out of MACRA (Medicare Access and CHIP Re-authorization Act) is expected to proceed, regardless of changes in the Affordable Care Act. MACRA is part of a broader push…
Medicare Payment Overhaul – Finally!
Senate Action on the “Doc Fix” On April 14, 2015 the Senate acted on a bill from the House of Representatives to implement a Medicare payment overhaul, including repealing the…
Even Hospital Billing Done Correctly can have Claims Denied by a RAC
Convinced that your hospital billing department is doing its job well, and yet your claims get denied by a RAC? You’re not alone. Did you know that in one study…
The Healthcare ACO … “What it is and why I should care”
The Accountable Care Organization, or “ACO”, is among healthcare’s latest trends. And what about the “Medical Home“? Is that the same as an ACO, or different? Some organizations, after their…
Physicians To Receive 30% Less From Medicare: Are You Still In?
A couple of today’s news headlines … “The Centers for Medicare and Medicaid Services has issued its proposed changes to the 2012 Medicare Physician Fee Schedule, including a long anticipated…
Medical Accounts Receivable: Monitoring and Measuring Performance
One of the common issues we confront when called to perform a physician billing department assessment, or a more broad based medical practice analysis, is the lament: “Why aren’t we…
Three Financial Strategies for your Medical Practice that are “Like Money in the Bank”
A question recently posted on LinkedIn regarding the “Do’s, Dont’s, Thrills and Spills” of using a lockbox for payments generated a lot of comments, and got me to thinking more…
An Operational Analysis of Your Medical Practice is a Logical Step in the EHR Selection Process
I’m often surprised by how some medical practices are so casual in their approach to selecting an EHR system. As if the EHR selection process itself is inconsequential. And I’m bordering…
Is it Time for your Medical Practice to Opt out of Medicare?
“I opposed the budget deal in 1997 because it brought in a $115 billion cut in Medicare that created greater pressure for providers not to participate.” ~ David Obey, U.S….
Using Best Practices in Medical Billing – the Key to Surviving Economic Conditions
With the existing economic hard times, it is very critical that medical practices and facilities keep an eye on their accounts receivable. A continuous flow of claims payment will determine…
Efficient Operations in Your Medical Practice … Be Serious About It!
With EHR technology being implemented, Health Reform just around the corner, and Meaningful Use criteria mandated, what else can there be? How about many more coding and billing auditing agencies…
Due Diligence in EHR Selection, can it help you Preserve Physician Productivity?
There are many commentaries, and anecdotal examples, of what happens to EHR Meaningful Use criteria will outweigh the incentive payments that are available. So maybe it’s time to take a…
