Understanding the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is vital because it changes how Medicare pays physicians for services as well as care delivery. It moves away from fee for service to value-based care. Not understanding the new policies, passed on October 14, 2016, will result in a penalty of negative 4 percentage! Those who work in the healthcare … [Read more...] about Answering your questions about MACRA
Billing & collections
Should your practice invest in medical billing software?
By Aiden Spencer bio There has been considerable debate among physicians about whether or not it is beneficial to get an EHR (electronic health record). If your practice is having this debate, let's evaluate the benefits and problems associated with an EHR and see if one is right for you. [Full disclosure: I have abundant experience in the field because I am working for a … [Read more...] about Should your practice invest in medical billing software?
CMS launches new online tool to make Quality Payment Program easier for clinicians
The Centers for Medicare & Medicaid Services (CMS) have released a tool to share automatically electronic data for the Medicare Quality Payment Program. This new release is the first in a series that will be part of CMS's ongoing efforts to spur the creation of innovative, customizable tools to reduce burden for clinicians, while also supporting high-quality care for … [Read more...] about CMS launches new online tool to make Quality Payment Program easier for clinicians
Look back to lead forward
By Cheryl Toth, MBA bio Every autumn, it's easy to get bogged down with next year's budget crunching, fret about the unveiling of Medicare's new conversion factor, or worry about the amount of this year's physician bonuses. Because in the harried life of a practice manager, it's easy to focus on what hasn't been done and forget just how many things have. So that's exactly … [Read more...] about Look back to lead forward
OIG celebrates 40 years of fighting fraud
October 15, 2016 marked 40 years since the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) was launched in 1976. It is now the largest inspector general with 1,600 employees and 70 offices and oversees $1 trillion in spending. The HHS OIG is charged with fighting fraud, waste and abuse in federal health care programs—primarily Medicare … [Read more...] about OIG celebrates 40 years of fighting fraud
How to deliver a great presentation on any topic
To grow in the job, a manager has to communicate ideas and visions and recommendations. And the presentation of them counts. "It doesn't matter how good the idea or how brilliant the insight," if it isn't well articulated, it fails, says Patricia Fripp, CSP, CPAE, a San Francisco executive speech coach. Worse, the manager's career can fail right along with it. Here are the … [Read more...] about How to deliver a great presentation on any topic
Staff work as a financial team and increase the up-front payments
With all its staff – front desk, billing, and clinical – working as a financial team, a North Little Rock, AR, surgery practice has increased its pre-surgery payments by 25 percent. “It’s not rocket science,” says Linda Atkins, manager of Neurological Surgery Associates. “It’s just common-sense things.” Every staffer “looks at the money picture” and has a role in it, she says, … [Read more...] about Staff work as a financial team and increase the up-front payments
$900 million in false billing results in charges against medical practices throughout the U.S.
Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell have announced an unprecedented nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts, resulting in criminal and civil charges against 301 individuals, including 61 doctors, nurses, and other licensed medical professionals, for their … [Read more...] about $900 million in false billing results in charges against medical practices throughout the U.S.
Industry challenged to create more patient-friendly medical billing
Furthering the goals of focusing on patients, coordinate health care delivery, and making health information more accessible, the U.S. Department of Health and Human Services (HHS) has launched a new challenge for all stakeholders in health care—designing a better medical bill that is easier for patients to understand. The HHS press release regarding the challenge notes … [Read more...] about Industry challenged to create more patient-friendly medical billing
Incorrect medical coding corrupts the core data used by health care facilities, has negative consequences throughout health care industry
Guaranteeing accurate, consistent medical codes and patient histories is one of the major challenges for providers and payers today. Medical codes are the starting point for understanding quality of care and making necessary improvements. "Medical codes are the core data used in every aspect of modern health care—every provider, payer, and facility relies on them," says … [Read more...] about Incorrect medical coding corrupts the core data used by health care facilities, has negative consequences throughout health care industry