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COMPLIANCE

4-step plan to return overpayments

Do you have to return plan overpayments? The short answer is, yes. Of course, you must return money that isn’t yours. In fact, to be compliant with Medicare and most commercial payers, once you discover an overpayment, you’ve got to refund it within 60 days. That’s the word from Michael J. Sacopulos, JD, founder and CEO of the Medical Risk Institute. “Sadly, I still speak with physicians who believe it’s okay to keep the money in the bank until the payer requests a refund. One large practice I work with told me they hadn’t run the credit balance report in nearly a year. When I suggested they do so, the Medicare credit balances alone totaled more than $300,000.” This is not the time to invoke “finders keepers, losers weepers,” he… . . . read more.

STAFFING

Is it a recession or not? The answer may surprise you

By Lynne Curry My in-box filled with questions after I posted a Recession Fears Loom blog. Readers asked how I made sense of the different views voiced by economists and politicians. As a medical office manager with responsibilities around staffing and profitability, you are probably watching to see which way the economy goes. Here’s the background, and my answer to “are we headed into a recession?”: Some say “yes.” Over 60 percent of the 750 CEOs surveyed by the business research firm Conference Board expect a recession in the next 12 to 18 months1. Another 15 percent of surveyed CEOs report their region is already in recession.1 The most recent gross domestic product report that tracks our overall economic health showed a second consecutive quarter of negative growth, the textbook… . . . read more.

MIPS

Submit your Promoting Interoperability measures and improvement activities

The Centers for Medicare & Medicaid Services (CMS) reminds you to submit Promoting Interoperability measures and improvement activities for consideration for future years of the Merit-based Incentive Payment System (MIPS). The MIPS Annual Call for Measures and Activities process allows clinicians, professional associations and medical societies that represent clinicians, researchers, consumer groups, and others to identify and submit measures and activities. Currently, CMS is accepting submissions for: Measures for the Promoting Interoperability performance category Activities for the improvement activities performance category What CMS is looking for For Promoting Interoperability: CMS is looking for specific measures that build on the advanced use of certified EHR technology (CEHRT) using 2015 Edition Certification Standards and Criteria; promote interoperability and health information exchange; improve program efficiency, effectiveness, and flexibility; provide patients access to their health information; reduce clinician… . . . read more.

HEALTHCARE DATA

Not ready for clinical analytics? Try operational analytics

By Aaron Brandwein Up until this point, our discussion about analytics in healthcare has revolved heavily around clinical analytics—and understandably so. The potential promises it brings to the table are huge, especially when you look at things like predicting clinical outcomes, identifying the risks for diseases and ailments, and helping practitioners choose better treatment plans. However, clinical analytics solutions can be challenging to get across the finish line and, in some cases, harder to even get to the starting line. Generally, they come with a higher price tag, more complicated integrations, and a much steeper challenge to secure the necessary buy-in to take the first step. So, what do you do as a healthcare provider who is interested in harnessing the power of analytics but is looking for a way… . . . read more.

PURCHASING

How to choose a healthcare analytics provider: A checklist

By Kevin Keenahan An effective analytics provider promises to bring novel data sets and insights to the table, optimize workflows, build efficient processes, and deliver superior financial returns in evolving value-based payment models. The challenge for buyers The “analytics” is a complex, nebulous family of functionality and the marketing noise surrounding many applications these days can be extremely misleading. Predicting what the product even looks like post go-live and how clinicians will end up adopting the application is often hard to nail down. Analytics itself covers several applications that all hold immense promise for healthcare applications. For instance: Computer vision solutions can automate diagnoses, Natural language processing can transcribe documentation and obviate simple and non-value-added tasks, and Big data analytics can parse through an ever-growing wealth of data to provide… . . . read more.

PRODUCTIVITY

10 tips for a more efficient medical office

What healthcare provider doesn’t want to see his or her business run more efficiently? After all, a well-run practice usually means increased revenue and happier, healthier patients. In the past, providers relied on smart hiring and organized employees to ensure their practices operated smoothly. But today, it takes a thoughtful blend of solution-based technology and old-school morale boosters to really make your medical office more productive without sacrificing quality of care and patient experience. From better break rooms to online appointment scheduling, read on to discover 10 proven ways to boost your medical practice’s efficiency. Enable online scheduling There’s perhaps no better way to lessen the workload of your administrative staff than with on-demand, 24/7 online scheduling functionality. Here’s how a simple “Book an Appointment” button can streamline operations for your… . . . read more.

INCREASING PROFITS

Denial management: the missing ingredient in revenue cycle management

By John McDaniel The blueprint for effective Revenue Cycle Management (RCM) is complex in today’s healthcare environment. When we map out the RCM process, it includes the following steps: Patient scheduling and registration Insurance eligibility and benefit verification Collection of copayments and deductibles at time of service Claims submission Remittance processing Denial management Back‐end patient collections Denial Management Implementing an effective and efficient process for managing claim denials is likely the single most important action a healthcare organization can make to affect its revenue cycle. Denial management is by no means a simple process; in fact, it is often extremely complex. According to the American Academy of Family Physicians, the average claim denial rate across the healthcare industry is 5 to 10 percent, varying between specialties. With the average cost… . . . read more.

TECHNOLOGY

5 tech resources improving medical practice efficiency this year

By Alison Foster bio There was a notable increase in the adoption of healthcare technology by practices and providers in 2020. This continues in 2021, especially as the COVID-19 pandemic shows no signs of letting up. Many practices are short on both human and financial resources and need to increase efficiency to the maximum. Here are some forms of healthcare technology you can rely on to optimize your practice’s efficiency in 2021. Cloud computing Keeping patient data safe and accessible is critical in healthcare. Traditional methods of storing patient data often have challenging retrieval and sharing processes. Cloud computing solves many of these problems and is fast becoming the go-to choice for many practices. Electronic health records stored on the clouds means that providers and authorized personnel can access patient data… . . . read more.

CMS

Medicare payment upped for COVID-19 vaccine

The Centers for Medicare & Medicaid Services (CMS) has increased the Medicare payment amount for administering the COVID-19 vaccine. This new and higher payment rate will support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting patient outreach and education, and hiring additional staff. For COVID-19 vaccines administered on or after March 15, the national average payment rate for physicians, hospitals, pharmacies and many other immunizers will be $40 to administer each dose of a COVID-19 vaccine. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines, and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment… . . . read more.

INCREASING PROFITS

The physician enterprise model: a non-employment alternative

By John W. McDaniel bio Hospitals are seeking new and innovative ways to affiliate with physicians that differ from tactics used in the 1990s, These new relationships involve a more formal type of relationship with physicians, which might reflect lessons learned through previous less‐than‐satisfactory relationships. Most hospitals have physician integration strategies as a part of their long‐range plans, but because physicians employed by hospitals lose approximately $190,000 per year, hospitals and health systems must explore alternatives to physician affiliation aside from the traditional employment model. Beyond employment Affiliation is sought for various reasons. Large hospitals seek a wider reach into communities, while small and rural hospitals seek help with physician recruitment, which has been troublesome over the past years due to 84% of senior medical residents desiring to practice in… . . . read more.


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