What can you do if your payer won't reimburse your practice for cleanly submitted claims?
Do you make the grade? Expert Susanne Madden explains what physician profiling is, how it can affect your bottom line, and what you can do about it.
With a growing shortage of primary-care physicians, NPs are fast becoming the resource of choice
Physician profiling is used by payers to steer their members to in-network physicians who, by their measures, are the most cost-efficient and provide the highest quality of care. Wonder if you’ve made the grade? Look yourself up in a provider directory: if you see a star or two beside your name, you’ve been profiled.
At least once a week I hear clients complain about difficulties they are having organizing simple work flow processes.
Medicare is getting more aggressive with audits through its Recovery Audit Contractor program. Here’s how to assess your billing procedures to avoid audits, and establish a process for when a RAC does come knocking.
I attended a managed-care business forum in Washington a couple of weeks ago to find out what initiatives payers have been working on recently.
Consultant Susanne Madden offers a step-by-step guide to handling payer take-backs and not getting bullied into writing a check without researching the situation.
Recovery Audit Contractor (RAC) is a term that every Medicare healthcare professional and staff member needs to know.
Where do your patient referrals come from? Do you know?