We normally look to the Supreme Court to make landmark decisions (like the Affordable Care Act), but the court rules on many smaller cases that — while they may not make it to the nightly news — still affect our daily lives. One of those is the May 2019 decision on Cochise Consultancy Inc. v. […]
How hard are your managed care contracts working for you? Could your payer contracts even be working against you? Payer reimbursements are the foundation of your practice revenue, but unfavorable contract terms can cost you thousands of dollars. Many providers find payer contract negotiation — or renegotiation — to be a complex and even uncomfortable […]
Using Medicare’s ABN form, Advance Beneficiary Notice might be a routine part of your job, but are you sure you’re doing it correctly and compliantly? Providers and staff who treat Medicare patients must know exactly how and when to issue a CMS ABN form to avoid costly write-offs and penalties. If you’re like most providers […]
Provider documentation is your only defense if you’re faced with an audit. It must be rock-solid to support the claims you submit to payers. But how can you ensure this happens when each clinician has his or her own style and perspective when documenting a patient encounter? The answer is good basic, defensible documentation. Here […]
Since many payer networks are already complete, it is often challenging for providers to get contracted. Therefore, the question is what can you do as a provider of valuable medical services to get into a closed or narrow payer network?
Patient survey results were recently published by Software Advice that uncovered that your patients are using wait times found online as a determining factor when deciding to make an appointment with you.
In the last few years, the number of providers that have received records requests from third-party companies hired by health plans has skyrocketed. The good news for providers and patients is that risk adjustment requests are NOT for determining the medical necessity of ...
You have be under the impression that you should never utilize unspecified codes. This is completely incorrect. Actually, when unspecified codes are used wisely, it can make a significant difference in your ability to get your claims paid.
You know what a pain HIPAA compliance is for your office. Well, significantly magnify that pain, and that’s telemedicine HIPAA compliance – unless you know what to look for...
Several weeks ago, a customer called and asked, “How long should we keep our patients’ medical records before destroying them?” Over the years, I’ve heard a variety of answers to this question, and it never seemed...