By Steve Selbst bio The purpose of this article is to help you, as a provider, to focus on three key items to look for in payer contracts that will help you to get profitable contracts in place. The three key areas that we will examine are fee schedule amendments, lesser of billed charges vs. contracted rates, and claims' payments. 1. Fee Schedule Fee schedules … [Read more...] about Three key items to negotiate for successful payer contracts
Billing & collections
You have less than one month to submit MIPS Year 2 (2018) Data for the Quality Payment Program
The Centers for Medicare & Medicaid Services (CMS) has officially opened the data submission period for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in Year 2 (2018) of the Quality Payment Program. Data can be submitted and updated any time until 8:00 p.m. ET on Tuesday, April 2, 2019. CMS Web Interface users need to report their … [Read more...] about You have less than one month to submit MIPS Year 2 (2018) Data for the Quality Payment Program
CY 2019 List of Medicare Telehealth Services
Why you need this tool: Has your practice recently implemented telehealth? If so, you might not know which CPT codes are available for reimbursement. How this tool helps you: This list, compiled by Nick Hernandez of ABISA LLC, will show you which CPT codes are currently (2019) available. How to use this tool: Refer to this list of codes when billing for telehealth services. … [Read more...] about CY 2019 List of Medicare Telehealth Services
4 best practices to help optimize your processes and increase your reimbursements
By Ranadene (Randi) K. Tapio, MBA, CMRS, CMC, Guest Contributor bio Revenue Cycle Management is multi-faceted. There may not be a right or wrong way as far as your process goes, but there are tips, tricks, and best practices that can optimize the process, and in turn, your reimbursements. After years of experience working with varying sized and specialty practices, … [Read more...] about 4 best practices to help optimize your processes and increase your reimbursements
5 proven levers for improving your medical practice
Virtually any medical practice can immediately improve its revenue, cash flow, profitability, and growth, along with streamlining its operations by embracing five levers for medical practice improvement. John W. McDaniel, founder and chairman of Peak Performance Physicians LLC of New Orleans, LA, says these five levers apply to any type of healthcare business, whether it is a … [Read more...] about 5 proven levers for improving your medical practice
Get personal to get patients to pay faster
Set the expectation of payment before the patient comes in. When the office calls to confirm an appointment, whether it's a live conversation or an automated message, say, "Your co-pay is due when you check in." In other words, "bring your wallet." Some offices go so far as to refuse people who don't have the co-pay at the time of the visit. However, such a strict policy … [Read more...] about Get personal to get patients to pay faster
How to determine the order of multiple insurance coverages
By Ranadene (Randi) K. Tapio, MBA, CMRS, CMC, Guest Contributor bio When patients have multiple insurance coverage, at times it can be difficult to determine which one is primary, secondary, and tertiary. Sometimes, the patients don't even know which order they go in! While there are always going to be exceptions, here are some basic guidelines to keep in mind: … [Read more...] about How to determine the order of multiple insurance coverages
CMS finalizes changes to the Medicare Physician Fee Schedule and Quality Payment Program
Last week, the Centers for Medicare & Medicaid Services (CMS) finalized proposals that it says will address provider burnout and provide clinicians immediate relief from excessive paperwork tied to outdated billing practices. The final 2019 Physician Fee Schedule (PFS) and the Quality Payment Program (QPP) rule also updates Medicare payment policies to promote access to … [Read more...] about CMS finalizes changes to the Medicare Physician Fee Schedule and Quality Payment Program
Polite form on chart collects balance due at registration
Because staff don't like asking patients for money, one manager set up a non-confrontational form that gets patients to pay their outstanding balances at registration. The billing department attaches it to the charts each morning, and the front desk staff hand it to patients with, "Oh, by the way, there is a note here for you from the billing department." The form was designed … [Read more...] about Polite form on chart collects balance due at registration
3 questions to help you handle patient credits
By Ranadene K. Tapio, MBA, CMRS, CMC, Guest Contributor bio How does your office deal with patient credits? More importantly, does your office deal with patient credits at all? Believe it not, not all offices do. There are several reasons why an office wouldn't address patient credits—from just not knowing they should to not knowing how to being short staffed. If … [Read more...] about 3 questions to help you handle patient credits