Maintaining a health revenue cycle in a medical practice comes with myriad moving parts. Numerous external forces, such as economic conditions, government programs (e.g., the Zone Program Integrity Contractor [ZPIC], the Health Information Technology for Economic Clinical Health [HITECH]) and legislation passed under healthcare reform, mandate healthcare organizations to begin managing internal processes, such as…
Physicians are increasingly fighting multiple forces in running a practice, and one of the most common barriers to effective revenue cycle management is frequent medical billing and claim denials. An insurance company’s denial for services places a significant strain on the financial process of the practice, which affects the bottom line. According to the Medical…
Like many people, I am up early and in the gym most days. Although I don’t seem to get anywhere new on the stationary bicycle or the elliptical machine, I do get to keep up with the pundits on the early morning talk shows. In contrast to the television series I binge on later in…
Overcoding is a common term used when discussing fraud and abuse in reporting procedures and services not supported by the actual work performed. Alternatively, undercoding—or failing to report the full extent of services or procedures provided—is an equally unsound practice and a compliance risk. In the world of quality reporting, undercoding can have damaging effects…
As the year draws to a close, it is vital to pay close attention to your practice’s revenue cycle to maintain an operational and financially healthy business. Operational aspects should be a top priority, with careful monitoring as they relate to efficiency in receivables and denials management. Healthcare revenue cycle management is the strategy that…
On Nov. 2, 2015, Congress passed the Bipartisan Budget Act of 2015. The Act contained a nasty surprise change to Social Security claiming strategies. Two commonly recommended strategies are known as file and suspend and restricted application. Both of these strategies will be going away, but not immediately. A lucky few will be grandfathered in….
Recovery Audit Program brings in record number of appeals, clogs system
In an effort to minimize medical fraud and abuse, the Centers for Medicare and Medicaid Services (CMS) has updated the signature guidelines for physicians and medical documentation.
The ACR is joining with the American Medical Association (AMA) in promoting November as “Heal that Claim” month.
Could you use an additional $50,000 to $80,000 in revenue each year? If you are like most clinicians, you have superbills and well-trained office staff but you still receive frequent denials. Though some denials are appropriate, many can be corrected and the lost revenue recovered.