All Blogs

All Blogs

Managed care contracts

Decipher Confusing Payer Contract Language & Get Paid More

If you’re among the medical practice staffers who groan when it’s time to review managed care contracts, that could be because you know payers bury confusing language into the documents. One step to understanding what these contracts say is to break down each section and look for key phrases that can help you reduce confusion […]
CPT code 99211

Check These Four Documentation Rules for Reporting 99211

Your nurses are vital to your office’s operations, and the income they generate is vital as well. But if you don’t ensure that they document their visits properly, you could be throwing thousands of dollars out the window. That’s because payers and government auditors are reviewing documentation for nurse-visit CPT code 99211, and if they […]
medical expert witness

Called as a Medical Witness? Ace Depositions, Trials & Hearings

When a medical provider is called to give testimony as an expert witness or a fact-based witness, chances are you don’t have the option of saying no. If you’re presented with a legal request, you should be as prepared as possible, and part of that preparation will involve knowing what to wear, say and do […]
outsourced medical billing

Evaluate Your Medical Billing Firm by Tracking These KPIs

Many practices find that outsourcing the billing function can help improve workflow at the medical practice, reduce errors, process claims faster and boost profitability. But if your billing partner isn’t providing you with reports, you may not be able to measure the most important key performance indicators (KPIs) that help you evaluate whether the relationship […]
patient abandonment lawsuit

Four Instances When You Should Never Terminate a Patient

Every practice experiences situations from time to time when they must terminate the physician-patient relationship. However, you can’t cut ties with even the most difficult patients until you first evaluate your legal obligations. In some cases, termination of the relationship is not a possibility due to medical credentialing or legal guidelines that require the provider […]
provider credentialing

5 Steps Help You Reach Payers, Speed Credentialing Processes

Getting payers to respond to your provider credentialing and enrollment questions sometimes feels impossible, but without their help, you won’t be able to process your applications, which means you can’t bill for new providers. There are, however, concrete ways you can reach insurers and get responses to your credentialing questions. Check out five expert-tested ways […]
No show patients

5 Strategies Help Reduce Medical Practice Patient No-Shows

No show patients have an annual industry impact estimated at $150 billion, and cost your practice about $200 per unused timeslot. In fact, some experts say practices lose an average of 14 percent of their potential earnings each year due to missed patient visits. Not only that, but no-shows mean that patients don’t get much-needed […]
risk adjustment

Risk Adjustment: Are You Self-Auditing ICD-10-CM Codes?

Medical practices can get paid more for Medical Advantage claims by accurately reporting patient risk—but the main way insurers evaluate risk is through your diagnosis codes. And if your practice isn’t performing ICD-10-CM self-audits, you could be underrepresenting your risk and shorting your practice significant income without even knowing it. Background: Risk adjustment is a […]
Access to medical records

5 Steps Prep You for Oct. 6 Information Blocking Rule Deadline

Medical practices have had a few years to comply with the HIPAA privacy and security rules, which means you’ve gotten a handle on issues like giving patients access to medical records in a timely manner and keeping their private information secure. But one area that you may not have mastered yet involves the Information Blocking […]
revenue cycle

Build the Ideal Revenue Cycle Team With This Quick Primer

The best way to ensure that you bring maximum revenue into your practice is to involve several key team members in the revenue cycle process so you can master every step along the way. And once you identify the participants, you’ll need to train them properly to keep the entire team running at maximum potential. […]