Denials management and appeals are the two most underestimated processes in rheumatology offices. Most practices lose thousands of dollars every year because they are not following up or writing off denied claims correctly.
Coding Corner Answer: May 2008
May’s Coding Answer
Aloha from the 2007 AMA House of Delegates Interim Meeting
The 2007 AMA House of Delegates interim meeting was held November 10–13 in Honolulu. The ACR was represented by its delegate, Melvin Britton, MD, and alternate delegate, Gary Bryant, MD.
How Medically Unlikely Edits Affect a Practice
Medically unlikely edits (MUEs), formally known as medically unbelievable edits, took effect with the Centers for Medicare & Medicaid Services (CMS) on January 2, 2007. The function of MUEs is to detect and deny unlikely CMS claims on a pre-payment basis with the intention of improving Medicare’s payment process.
Mind Your Accounts Receivable
Over time, one would expect financial management of a medical practice to become more streamlined and simple. With the abundance of electronic tools, software programs, and the Internet, you can find assistance and problem-solving strategies for economic efficiency. In the rush to take advantage of these support tools, basic facets of financial management, such as billing and collection, have fallen by the wayside.
The Symptoms or the Disease
Where should we focus?
Missed Appointments Equal Missed Revenue
What do you do when a patient misses an appointment? While an opening in the schedule might seem like a good time for staff to take a break or catch up on their to-do lists, missed appointments are a growing problem in physician practices. With today’s need to maximize every dollar, practices should take a closer look at the effect these missed appointments have on their bottom lines.
Clean Claims Equal Prompt Payment
Submitting a clean Medicare reimbursement claim the first time can save your practice thousands of dollars each year. The Centers for Medicare and Medicaid Services (CMS) defines a clean claim as “a submitted patient claim form without any defect or need for substantiation.”
Plan for Success in 2008
We’re ready for the rewards and challenges of the coming year
National HMO Class-Action Case Settled
The latest development in the healthcare class-action settlement will affect approximately 900,000 physicians (and some major state medical societies) who may be eligible to receive compensation from the settlement – as long as they file a claim. The case has been called “historic” by those representing both physicians and insurance companies.
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