February 26th 2024
Your weekly dose of wisdom from the Physicians Practice experts.
October 25th 2023
MGMA Senior Vice President for Government Affairs, Anders Gilberg, discusses some of what’s the organization is anticipated in the 2024 Physician Fee Schedule.
August 23rd 2023
Collecting money from patients is an ongoing challenge that has only worsened with high-deductible health plans.
July 31st 2023
May 22nd 2023
What States Make Patients Pay Out of Pocket the Most?
What state allows for almost 50 percent patient responsibility? Also, which services have the highest percentage of patient responsibility?
Educating Patients on Health Insurance Benefits
Spending a few minutes explaining health insurance benefits to patients prior to the appointment should become a requirement.
A Conversation on MACRA with a Family Physician
Physicians are frustrated with the lack of clear specifics on how they will meet quality metrics to avoid a negative payment adjustment in 2019.
Coding for Coordination of Patient Care
Physicians who spend significant time coordinating a patient's care may realize reimbursement in several ways.
8 Things Your Medical Billing Service Should Do
A good vendor does more than just submit claims and hope for the best. Here are eight things you should expect from your medical billing service.
Why Should Medical Billers Get All the Blame?
When you read reviews on online review sites, you typically read about the physician. But have you ever read how awesome the billing experience was?
Medicare Consult Denials; Coding for Unusual Services
Our coding expert discusses what to do when Medicare denies a consult code; preparation for Medicare chart audits; and coding for unusual services.
7 Ways Small Practices Can Maximize Their RCM
It's not impossible. Smaller providers can maximize their RCM and increase their bottom line; here are seven ways to do just that.
More on Inappropriate Billing for Dual-Eligible Beneficiaries
In the second of a two-part interview with a CMS representative, more on the legal ramifications for waiving copays for low-income patients.
Important Caveat to Waiving Patient Copays
Most practices know they are obligated to collect patient copays and deductibles, but few know that for certain low-income patients doing so is illegal.
What Should Practices Know about Waiving Copays?
Government and commercial insurers have different policies practices must know about waiving copayments. What do practices have to know?
The Case to Ignore "Incident to" Billing for PA Services
Here's why you should ignore "Incident to" Billing for PA services, which require a significant amount of additional work without a fair return in revenue.
Coding for Advanced Care Planning
Answers from our coding expert on questions regarding advance care planning; pessary cleaning; and identifying inclusive codes.
Designing Your New Medical Office Space
If your practice is considering an office redesign or building a completely new space, make sure you ask the right questions first.
How Practices Are Faring with ICD-10 at Six Months
Was the fear and trepidation surrounding ICD-10 overstated or is the early success around a lack of denials only temporary for providers?
Four Consequences That Will Derive From MIPS
The Merit-Based Incentive Program could mean more practice buyouts and increased complexity between Medicare Parts A and B.
Keeping and Growing a Patient Base
In order to improve customer satisfaction to attract and retain patients, practices can take these three basic steps.
Test Your Knowledge on Waiving Copays
Do you know why you shouldn't waive patient copays? Take this short true and false quiz to find out what you really know.
Don't Write Off Patient Copays
It comes naturally to want to help your poorest patients. But before waiving patient copays, consider the legal consequences first.
Understanding Your Claims Denials
When you look at your cash inflow each month, are you disappointed? That's why it is so important to identify why your claims are being denied.
Despite Minor Issues ICD-10 Rollout Is Smooth
Since the implementation of the ICD-10 coding system, most claims are processing smoothly and rejection rates have been minimal.
Changes to Incident-To Billing; Time-Based Coding
Answers from our coding expert on questions regarding incident-to billing; time-based coding; and specificity in ICD-10.
Four Things to Know About the 2016 OIG Work Plan
Simple Medicare Enrollment through PECOS
Enrolling or revalidating clinical staff in Medicare just became much easier for this billing services provider.
Making Patient Payments Prompt and Painless
With some planning, staff cooperation, and the right technology vendors, one practice shows that getting patients to pay can be done more effectively.
Rising Healthcare Costs May Mean Increased Liability for Docs
More insured patients will be paying more out-of-pocket expenses and higher deductibles for their care. This could be bad news for docs.
With 60-Day Rule, Practices Cannot be Lax with Overpayments
If your practice hasn't already, make sure to hire an outside auditing firm to review your billing records for possible overpayments.
Providers Share Frustrating Payer Experiences
Most providers can probably share "war stories" over frustrating experiences they've had with a payer. Here are a few we've accumulated.
Spelling Out Medical Necessity; Duplicative Coding
Answers from our coding expert on questions regarding medical necessity; using the ROS for history of presenting illness; and duplicative coding.
What It Takes to Get Paid at Your Medical Practice
How can practices know what they are getting paid, if they are not tracking payer reimbursements and running financial reports?