. ARMCO Partners provides high quality forensic billing, clinical abstracting, NCCI edit resolution/denial management, and ICD-10 medical coding services for hospitals, physician networks, and home health/hospice services.

The utilization of telehealth services has increased significantly over the past few years, as those in the healthcare industry have started to realize the 

 it offers. Telemedicine allows organizations to maximize existing service lines; add new specialties without the associated costs and hassle of hiring full-time, in-house clinicians; and increase patient satisfaction. It also provides better work-life balance for clinicians, helping to alleviate the issues associated with the burnout crisis. However, in retrospect, the growth over the past few years will likely pale in comparison to the dramatic growth the industry is experiencing due to the COVID-19 crisis.

COVID-19 has initiated a major uptick in the adoption and utilization of telehealth services, allowing patients to safely receive care and clinicians to provide it, often from the comfort of their own homes. In March 2020, the global telehealth market was 

 to reach $82.03 billion by 2027, with a forecasted compounded annual growth of almost 18 percent. Now that telehealth has become—and is likely to remain—the new normal, those projections are expected to increase. In fact, LocumTenens.com has seen a 32 percent increase in clinicians working telehealth assignments since the crisis began.

The necessity of telehealth services during the pandemic has caused many in the healthcare industry to realize what so many of its proponents have long claimed: receiving care via telemedicine is not significantly different, and is often preferential, to receiving care face-to-face. A primary differentiation, in fact, lies in an administrative duty rather than a clinical responsibility: billing.

 Marketing and promotion strategies for medical practices

were enacted to make telehealth services more accessible during a time of crisis, reimbursement for telemedicine had started to improve. And with many healthcare organizations struggling financially due to cancelations of elective and non-urgent procedures, collecting telehealth revenue can be incredibly beneficial.

Billing for telemedicine services doesn’t have to be overwhelming when you understand a few key concepts and take advantage of your available resources.

Anyone who has performed medical billing is familiar with CPT codes, but what a lot of them have never worked with before are GT modifiers. GT modifiers are simply added to a CPT code to show that the service was rendered via telemedicine. You can find a list of examples of CPT codes modified for telehealth services 

One of the most important steps you can take toward successful telemedicine billing is to get to know your payor mix. It’s important to understand what percentage of your patients utilize Medicare, Medicaid, and commercial insurance so you can recognize how to properly bill for each. Don’t be hesitant to reach out to your representatives from each specific insurance entity, either. They’ll be able to provide you with a wealth of information and answers to important questions. For example, is there a cap on the number of telehealth sessions your patient can have per year? Does the telehealth session have to be synchronous? Billing in general is nuanced and complex. These experts can help you get it right.

Telemedicine billing and reimbursement laws vary by state. You’ll need to gain a solid understanding of your state-specific telemedicine billing legislation, and it is equally as important to check regularly for updates, especially given the continuous legislative changes that are making telehealth more accessible.

Wearables and EHRs: Things you should consider

Work with an agency that will provide billing assistance

Although there’s a growing number of telehealth vendors, it’s important to keep in mind that they’re not all created equal. A reputable company will be able to offer you assistance with billing as necessary and might partner with an outside agency to ensure they’re able to provide you with the best service possible.

The growth of the telemedicine industry isn’t slowing down. Don’t let billing for telehealth services hold your organization back from reaping the tremendous benefits telemedicine affords both clinicians and patients.

, DNP, FNP-BC is Director of Telehealth at

. LocumTenens.com specializes in the temporary placement of physicians and advanced practitioners at U.S. healthcare facilities.

Articles

Untangling telehealth billing

Weight management is more than just a checklist– Julia Wright, MD gives insights into discussing weight and nutrition, and planning behavioral health modifications with patients based on her experiences at OnTrak.

Videos

Weight management is more than just a checklist. 

Strategies for discussing diet and nutrition with patients

 is a Director on the Medicaid Transformation Project at 

 where he leads work in behavioral health, chronic care, substance use disorder, and Medicaid population health strategy. Prior to AVIA, Victor spent nearly 10 years at Oliver Wyman helping large healthcare organizations navigate the transition to value-based care. He holds a BA in Economics from Northwestern.

Even before the emergence and spread of COVID-19, the US was experiencing a behavioral health treatment crisis: 

 showed that only 43 percent of adults with mental health needs, 10 percent of individuals with substance use disorder (SUD), and seven percent of individuals with co-occurring conditions were able to receive 

The treatment gap is staggering, and COVID-19 is making it worse: an estimated 

 report the pandemic has negatively impacted their mental health. Worse yet, the crisis is felt most acutely by the same health delivery systems that must deal with COVID-19 itself. Hospitals, health systems, and clinical practices—together with other first responders—are the front line. They bear the burden of their own stress and must also cope with the many patients who present with a range of mental illnesses and substance use disorders.

Digitally-enabled care models enable health systems and health plans to meet their most urgent needs in the era of COVID-19. Some solutions also help systems take advantage of favorable, albeit time-sensitive conditions, enabling them to lay the foundation for permanently expanding behavioral health services in the post-pandemic period.

7 Financial Reports Your Practice Needs to Run

A pressing need for health system leaders is keeping their workforce healthy, focused, and productive during this period of extreme stress, anxiety, and trauma. The need for ongoing, easily accessible behavioral health resources for the healthcare workforce will only grow as the pandemic continues.

: Consider providing immediate, free access to behavioral health solutions for employees and their families. Also consider extending access to first responders, other healthcare workers, and other essential services workers in the community.

Many digital solutions are granting temporary access to these services and are expanding their offerings to include new, COVID-19-specific modules, resources, and/or guidance at no cost.

The following are a few digital solutions to consider:

Recovery management tools for individuals with SUD.

 Organizations are using these to address loneliness and social isolation in group-based chat settings, one-on-one interactions between individuals and peer staff, and broader community applications.

Online cognitive behavioral therapy (CBT) solutions.

 These tools are being used to expand access to lower-acuity behavioral health services, targeting both frontline workers and the general population.

Focus Area 2: Individuals with Acute Behavioral Health Conditions

During surge periods, the overwhelming focus is on containing and treating COVID-19; this disrupts services that are essential for individuals with severe mental illness and SUD. Maintaining continuity of care will be critical to preventing decompensation of these patients, which could drive increased rates of ED visits and admissions.

 Many digital companies are hosting virtual recovery meetings and providing access to virtual peer support groups. Additionally, shifts in federal and state policies are easing restrictions around critical services, including medication-assisted treatment (e.g., buprenorphine can now be prescribed via telephone), that can mitigate risky behavior and ensure ongoing access to treatment. The following are several solutions to consider:

Medication-assisted therapy (MAT) via telemedicine.

 These solutions provide access to professionals who can prescribe and administer MAT medications, provide addiction counseling, and conduct behavioral therapy (e.g., CBT, motivational interviewing) digitally.

 Providing screening, therapy, and psychiatric consultations across settings of care—especially primary care—will help with the increased demand.

RVUs: The basics of physician compensation

Healthcare organizations should also look to new funding opportunities to develop digital infrastructure that expands access to critical services. Specifically, as part of the CARES Act, the FCC launched the COVID-19 Telehealth Program and extended the Connected Care Pilot Program to provide avenues for immediate funding for such implementations. Additional telehealth opportunities, including reimbursement for audio-only services and temporarily eased provider licensure requirements, have further paved the way for expansion of tele-behavioral health capabilities.

COVID-19 has brought the behavioral health crisis to the foreground and the marketplace is brimming with innovative solutions. The moment to act is now: health systems that double down on behavioral health today will emerge from the pandemic response well-positioned, having built healthier, stronger communities and workforces along the way.

An estimated 56 percent of adults report the pandemic has negatively impacted their mental health.

Leveraging digital and policy tools to address the COVID-19 Behavioral Health Crisis

In most states, medical practices are re-opening and ramping up patient volume. Appointments and procedures are increasing, and physicians are eagerly anticipating an increase of cash flow compared to the past three months.

However, the dismal unemployment numbers suggest that patient balances will be increasingly difficult to collect. 

Here are seven ways to increase patient payments.

7 ways to increase patient payments

 who advises physicians on practice management and revenue cycle. Amy is a former physician practice administrator.

Slideshows

Practices who fail to be proactive about collecting from patients will predictably experience a tsunami of accounts receivable.  

Zachary is the Financial Controller at Family Allergy and Asthma. An experienced Controller, Zachary has held financial positions at many well-known companies including Castle & Key Distillery and GE Appliances. He has a MS focused in Accounting from The University of Akron.

, was founded in 1979 and is a group of board-certified allergy and asthma specialists with offices in Kentucky, Indiana, Ohio, and Tennessee. We currently operate more than 50 clinics with over 30 Board-certified allergists and physicians.

Like many businesses, we are continually looking for ways to streamline our operations, maximize cash flow and create better processes. One thing we have recently tackled is our accounts payable (AP) process.

We regularly work with hundreds of vendors from immunotherapy drug manufacturers for things like wasp serum, to medical suppliers to Staples for office supplies. But, none of our transactions are PO-based, as departments place orders as needed directly with vendors.

As such, our finance team has had little insight into the AP pipeline. Until recently, we didn’t have any visibility into invoices until the order arrived. With the majority of our 400 monthly invoices coming in via postal mail, processing was manual and slow. Our accountant hand-coded each invoice and managed approvals among fifteen people.

We knew there must be a better way, so a few months ago we began looking for new technologies to help. It was especially important that any new solution would integrate with our enterprise resource planning (ERP) system.

The work-from-home order due to the COVID-19 pandemic came in just as we were implementing our new automated solution, Stampli. Fortunately, we were able to get set up in about one day and our 15 invoice approvers trained quickly.

Automating our AP function has fundamentally changed the way we do business for the better.

. We can easily and quickly identify who has what invoice and its status in the approval process. It’s easy for our approvers to ask and answer questions in real time, track approvals, and establish an audit trail—all without anyone having to be onsite.

We have reduced our invoice lifecycle from 10 to 3 days

. Our invoice lifecycle used to take up to 10 days, and with that came the risk of late payments and potential fees. Now it's been shortened to about one day per approver, so three days total—that’s a 70 percent reduction in the invoice lifecycle.

We are 90 percent faster getting invoices into Intacct.

 We’ve gone from 10 days to just one day to get all invoices into our existing ERP system, and that's a 

 value add because it gives my team insight into all invoices so we can better plan. Additionally, with the COVID-19 crisis, cash flow management has become more critical, and our solution’s search capabilities allowed our team to quickly manage it by identifying outstanding invoices for payment.

Marketing and promotion strategies for medical practices

Big changes—like pivoting to telemedicine—are less painful

. Right after our invoices were automated, our IT director was tasked with rolling out telemedicine to enable providers to treat patients who were sheltering in place. Suddenly he had a huge project to implement, and at the same time a growing number of invoices to approve. With full visibility into all invoices, we were able to identify which ones needed his approval, reduce his load, and enable him to focus on other projects.

The combination of the pandemic and how much our AP process has improved has shown our company the need for digital automation. From an accounting systems’ perspective, we’re at the beginning of what we will do with automation and new we have the foundation to establish future growth.

A few tips for practices and physician offices looking to automate some of their financial processes:

Find solutions that integrate with your Accounting system. Avoid implementing multiple systems that do not communicate.

Secure buy-in from the accounts payable team that is performing the day-day work.

Make the case to the powers that be in dollars and cents (i.e. how much automation will save)

Zachary Kulow is the Financial Controller at Family Allergy and Asthma. An experienced Controller, Zachary has held financial positions at many well-known companies including Castle & Key Distillery and GE Appliances. He has a MS focused in Accounting from The University of Akron.

How new technology is curing ailments and streamlining processes in one practice’s AP department.

Automating accounts payable

Weight loss programs are hard to initiate and hard to sustain. Such a program would need to maintain sustained visits over time—a prime opportunity for telehealth offerings. Julia Wright, MD discusses how telehealth offerings can benefit both physicians and patients working together to take back control of obesity.

Weight loss programs are a prime opportunity for telehealth offerings.

Telemedicine benefits patients struggling with their weight

is CEO of Fund-Ex Solutions Group, a non-bank SBA lender and wholly-owned subsidiary of Bankers Healthcare Group. For more information, visit

For most physicians, the last few months have been some of the most trying of their careers. For practice owners specifically, prioritizing staff and patient safety while also balancing the financial health of their business has been a day-to-day endeavor.

The SBA’s Paycheck Protection Program provided much-needed support and stability for physicians who sought to maintain their employees during this time. If you received a PPP loan, you may now be juggling reopening your practice with preparing to apply for loan forgiveness.

First, borrowers should be aware of the provisions in the recently passed PPP Flexibility Act, which helps borrowers better qualify for forgiveness. The Act reflects several key changes relevant to forgiveness:

Borrowers now have 24 weeks to use their funds, as opposed to the original eight weeks. However, those who took out loans prior to June 5 have the option to use the original eight-week period, if they prefer, while loans originated after June 5 will be required to use a 24-week covered period.

Non-payroll expenses that can be forgiven has increased from 24 percent to 40 percent.

Any portion of the loan that is not granted forgiveness can now be repaid over five years, increased from the original two years, though the extension must be mutually agreed upon by the borrower and lender for all loans originated before June 5.

Borrowers do not have to make any payments on the unforgiven portion of the loan until SBA makes a final decision on the forgiveness application. If no such application has been filed, payments begin after 10 months.

Employers have until Dec. 31, 2020 to eliminate a reduction in full-time employees or salary that would otherwise reduce the forgivable amount.

When it comes to the loan forgiveness application, it may seem daunting to enter another unfamiliar process, it doesn’t have to be. Here are some facts that physicians need to know now:

5 questions to ask about wRVU compensation

1. The PPP was designed to cover payroll-related costs.

As indicated by the name, the PPP was created to cover costs related to your staff’s compensation. Most loan amounts were calculated at 2019 payroll expenses, which includes expenditures such as:

Employee salary or wages, commissions, cash tips, or similar compensation

Payment for vacation, parental, family, medical, or sick leave

Payment required for the provisions of group healthcare benefits, including insurance premiums 

Payment of state or local tax assessed on the compensation of employees

Compensation to or income of a sole proprietor or independent contractor 
up to $100,000/year

However, some non-payroll costs, such as interest paid on your mortgage, rent payments, or utility bills may be forgiven under the PPP, so long as they make up nor more than 40% of your total loan. Non-payroll expenses must be subject to mortgages, leases, or utility contracts that were in place prior to Feb. 15, 2020. PPE, a major cost for physicians reopening their practices, is not covered by the PPP, and therefore funds that are allocated to this purpose will not be forgiven.

2. 100% of your PPP loan can be forgiven.

It’s true—your PPP loan can be forgiven entirely if you follow certain criteria and you can prove the funds were spent accordingly. For instance, make sure that you’re using your funds for explicitly approved purposes only, and that you’re spending the entirety of your loan within the covered period. Any funds that are not used according to the guidelines will become part of the balance you have to repay.

3. You must provide proof of your expenditures in order to submit them for forgiveness.

First, make sure that you have the right forgiveness application. The SBA recently released a revised full version and a new short version (the Form 3508EZ).

The EZ application can be used by self-employed individuals, independent contractors, sole proprietors with no other employees, or any other borrower who did not reduce the number of full-time employees during the covered period or did not reduce pay for any employees by more than 25 percent (full-time employee and salary levels are compared to a pre-pandemic reference period to determine any reduction). Borrowers who don’t meet these criteria must complete the full application.

Keeping detailed documentation of your PPP-related spending is critical for ensuring maximum loan forgiveness. Some examples of acceptable documentation include forms such as paid checks, payroll documentation, receipts, billing statements, and more. The more diligent you are in maintaining and organizing your proof documents, the easier it will be for your lender to process your loan forgiveness application in a timely manner.

Will a waiver protect me from COVID-19 infection claims?

4. You apply for PPP loan forgiveness through your lender

Your financial institution has 60 days to review your application and return with a decision about your loan forgiveness. From there, the lender submits it to the SBA, which then has 90 days to finalize the decision and remit funds to the lender in the amount forgiven. The lender will notify the borrower of the decision.

The SBA has released a standard forgiveness application, as well as guidelines for applying and details about the documentation required to do so. Borrowers may submit forgiveness applications any time on or before the maturity date of the loan, and will have to start making payments on the full loan amount if a forgiveness application has not been filed within 10 months of receipt of PPP loan funds. You want to be sure that your application is complete and correct, so that you can be confident that you’ve done everything you can to maximize your forgiveness.

Applying for PPP loan forgiveness is a critical final step for physicians who took the financial initiative to safeguard their staff and their practice during this uncertain time. Making sure to use funds correctly, document your expenditures, and apply with confidence will set physicians up to receive the maximum forgiveness on their loan, and get back to doing what they do best–caring for their patients.

Applying for PPP loan forgiveness is a critical final step for physicians who took the financial initiative to safeguard their staff and their practice during this uncertain time. 

PPP loan forgiveness: What physicians need to know

Physicians in these five states reported the highest incomes compared to their peers in other states.

Setting up a practice, or just generally working for a health system, in these states might fare better; however, you must also consider the 

 and other competition that might already be residing there.

5 states with the highest physician salaries in 2019

Find out in which states you can make the most for your services. Will the rankings surprise you?

Best states for physicians in 2020: 5 states with the highest physician salaries

M.D. is Chief Strategy Officer and Chief Privacy Officer for

. He is a board-certified cardiologist and internal medicine specialist with over 40 years of clinical practice and is a past president of the Massachusetts Medical Society.

When considering the importance of medication adherence, former 

 said it best: “Drugs don’t work in patients who don’t take them.” That was 35 years ago, and the issue remains a major area of concern for clinicians today.

of new prescriptions are never filled—and even when filled, 

 with chronic conditions fail to take their medications as prescribed. These statistics reflect the situation before COVID-19 led to social distancing and stay-at-home orders that may be making the situation worse.

Medication non-adherence can lead to serious health consequences and higher medical costs. Each year, 

 results in approximately 125,000 deaths and up to 25 percent of hospitalizations, which is estimated to cost the American healthcare system nearly $300 billion.

As the number of coronavirus cases continues to grow across the U.S., medication adherence has never been more critical, especially for the elderly and those with chronic conditions who are the 

 to complications, including death, from COVID-19, according to the Centers for Disease Control and Prevention (CDC). To protect our most vulnerable patients, physicians and pharmacists must work together to identify the underlying reasons why patients aren’t taking their medications as prescribed and to provide solutions that improve adherence.

There are three primary reasons why patients don’t fill new prescriptions or take their medications as directed: high cost, lack of symptoms, and forgetfulness.

A major contributor to medication non-adherence is high out-of-pocket costs for prescription drugs, as evidenced by the 

 of a recent consumer survey. In the study, 48 percent of respondents reported not filling a prescription within the past few years because of cost. The research also found that even a $10 rise in copay increases the likelihood of prescription abandonment by as much as 19%.

 a direct correlation between the amount of a patient’s copay and the likelihood of prescription abandonment. Patients with $50 copays were nearly four times more likely to abandon a prescription at a pharmacy than patients paying $10.

Today, millions of Americans have lost their jobs, their health insurance, and the incomes they used to pay for out-of-pocket healthcare costs. One in seven report they would avoid seeking care for potential COVID-19 symptoms because of cost concerns, according to a 

. Unless patients find some financial relief, medication non-adherence rates will surely rise.

Lack of symptoms and misunderstanding of disease impact

Patients often do not understand why they need certain medications. It’s not uncommon for a person to say they don’t feel their blood pressure is high or that they don’t have any symptoms from high cholesterol. Because they don’t 

sick, people may stop taking their medications, which can have serious consequences that add up over time. This situation often leads to unnecessary visits to the ER and, occasionally, hospital admissions that could have been avoided.

During the current health crisis, we have all been encouraged to stay at home, limit trips to the grocery store and pharmacy, and postpone non-essential medical care. This means patients may have less interaction with physicians and pharmacists who can educate them about prescribed therapies. Now is the time for care team members to adopt proactive measures to make sure patients understand what their medications are for, how to take them, and why doing so as prescribed is important.

 9 ways to improve your patient communications

Delaying or forgetting prescription pickup

Even in our former everyday busy lives, it was easy enough to put off a trip to the pharmacy for a prescription. Now, as many of us still remain sheltered at home, it’s a challenge to recall what day it is, much less remember to pick up a prescription.

Using reminder tools that notify patients when medications are prescribed and when they are ready for pickup, pharmacists and physicians can help reduce prescription abandonment. Many independent pharmacies and national chains are offering free delivery services for prescriptions, which is particularly beneficial for patients who feel leaving home could compromise their health. Additionally, health plans have eased restrictions on filling prescriptions in larger quantities, reducing trips to the pharmacy.

Improving medication adherence with technology

Care team members can improve medication adherence—and health outcomes—by leveraging technologies that provide price transparency, offer access to educational materials, and send reminders directly to patients’ mobile devices. Technology also can facilitate secure communication between prescribers and pharmacists.

For example, when prescribers see patient-specific drug pricing detail

 at the point of encounter within prescribing workflows, it empowers them to discuss formulary options and out-of-pocket costs with patients, and potentially review financial assistance options if cost is a barrier. Real-time price transparency tools improve medication adherence and clinical outcomes because patients know exactly how much their medication will cost before going to the pharmacy. These tools eliminate the all too common “sticker shock” experienced by the patient when the pharmacist accesses the patient’s specific health plan benefit to discover that the medication is unaffordable for the patient.

Care providers can also reduce financial barriers with new technology that gives patients direct access to copay assistance options. Emerging solutions also may link patients to educational content about prescribed medications, giving them a better understanding of the prescribed therapy.

Patient-centered care in an interoperable environment

Better communication between pharmacists and doctors can improve adherence

Physicians and pharmacists can further drive adherence by sending automatic reminders to patients’ smartphones, for example, to notify them when a prescription is sent to the pharmacy or when a prescription is ready. Such tools also may allow patients to set reminder notices to pick up their medication. By committing to a specific time, patients are more likely to pick up their prescriptions and are more likely to take them.

Sometimes, prescriptions are not filled in a timely manner because the pharmacist needs additional clarification from the physician or the payer. For example, a pharmacist may place a call to the physician and leave a message, which starts a time-delaying game of phone tag. To increase efficiencies, improve coordination, and ultimately fill prescriptions more quickly, a patient’s care team can alternatively communicate directly using secure texting, email, and videoconferencing technology.

The novel coronavirus has impacted every aspect of our lives and created tremendous financial and emotional strain for many of our most vulnerable patients. Now more than ever, healthcare professionals must help patients overcome any hurdles standing in the way of medication adherence, including financial and safety concerns. With the right communication and educational tools, providers can help ensure patients take the medicines they need, especially those managing chronic conditions or at the highest risk of complications.

Medication non-adherence results in approximately 125,000 deaths and up to 25 percent of hospitalizations annually. 

Improve medication adherence with technology

The designation of the COVID-19 pandemic as a national emergency led to both changes in and an increase in the use of telehealth services. Telehealth encompasses a broader away of remote healthcare services than telemedicine because it includes both clinical and non-clinical services. For purposes of this article, we’ll focus on telehealth during the COVID-19 pandemic, with the caveat that providers need to stay abreast of the following:

permanent changes to existing state and federal laws after the end of the pandemic; and

reimbursement codes and settings for providing telehealth services.

In 2018, the Department of Health and Human Services Office of the Inspector General (“OIG”) published a report, 

CMS Paid Practitioners for Telehealth Services that Did Not Meet Medicare Standards

. This related to the telehealth before the COVID-19 waivers. Notably, there were no concerns with physicians reassigning billing rights to hospitals. But the OIG did find that “[f]or seven claims, institutional providers billed outpatient claims for telehealth services performed at distant sites for beneficiaries located at rural originating sites, but the distant sites were not CAHs, and the services provided were not MNT services.” Therefore, underscoring that billing under Medicare Part A or Medicare Part B is material. This should not change under the COVID-19 pandemic.

Periodically, the Centers for Medicare and Medicaid (“CMS”) releases updates related to different waivers and telehealth coverage. A good example is the 

 that was posted on May 11, 2020, which included a video update the types of services and correct billing for telehealth services.

A related issue which physician practices and hospitals should be aware of is the reassignment of Medicare benefits through utilizing a 

 First and foremost, providers should refresh themselves that telemedicine services are meant to prohibit kickbacks for referrals. Medicare Audit Contractors (“MACs”) have confirmed that a hospital can submit claims for a physician’s distant site telehealth services when the physician has reassigned his or her benefits to the hospital. The restrictions found in the regulation and Medicare Manual, simply state that the hospital cannot be the distant site provider. 66 Fed. Reg. 55332, 55282 (Nov. 1, 2001). In order to obtain reassurances that the hospital and the physician’s office are acting in accordance with the relevant laws and regulations providers should contact their MAC.

Overall, providers on both sides of the agreement should ensure that all actions associated with telehealth are above-board. The best way to mitigate risk is to call a MAC, read the laws, and the telehealth waivers over COVID-19.

Healthcare technology shouldn’t disappear with COVID19

, JD, MBA, advises clients on compliance and transactions in healthcare, cybersecurity, corporate and securities law, while representing plaintiffs in False Claims Act and Dodd-Frank whistleblower cases. She also teaches bioethics at

in Houston. Rachel can be reached through her website,

The best way to mitigate risk is to call a MAC, read the laws, and the telehealth waivers over COVID-19.

Reassigning Claims? Make sure to complete the CMS 855-R Form

What are the best states for physicians to practice in? Find out in Physicians Practice Best States to Practice 2020 exclusive data project.

For our analysis, our editors ranked the states based on 2019 data covering five categories:

Tax climate (state collections per capita)

Physicians Practice obtained the data from publicly available sources and partner organizations.

 provided malpractice premium averages for each state.

Here’s a brief description of our methodology: We ranked each state on the criteria described desirable outcome per criteria, then averaging those scores resulted in the ranks of the states below and in other sequences in the slideshow series.

Below is a collection of the full ranking of all states and territories included in our 2020 analysis. 

Best States to Practice: 2020 Rankings

Here is the full 2020 ranking of all states and territories included in this years' analysis. 

The best states for physicians in 2020: The complete ranking

. They have succeeded in making the recovery of accounts receivable a profitable endeavor for more than four decades. Today, they use automation technology partnered with the experience of their attorneys and staff to seamlessly integrate with their clients; manage compliance in multiple jurisdictions; and collect for their clients. For more information, visit www.thefishmangroup.com or call (248) 353-4600.

Despite countless phone calls and emails, you’re still waiting on payment from a client, which can obviously be frustrating. Certainly, sympathy is called for when the client is going through a difficult situation, especially considering the times of crisis we’re living in now. But when you have people on your payroll and expensive equipment and materials to pay for, the survival of your firm can depend on the conversion of these accounts into cash. At a certain point, you have to concede that it’s not something you can handle on your own, and you send it a 3rd party collections firm. The most often pursued options are collection agencies and collection law firms, and the differences between the two are important to note in your consideration of your collection strategy. In terms of their success in pursuing collections and the exceptional caution they exercise in representing your practice, collection law firms prove to be a superior option for firms looking for third-party collections.

The differences between collection agencies and collection law firms mainly lie at the tools they have at their disposal in pursuing collection. Collection agencies tend to utilize persistence as their main tactic with debtors. They’ll call and ask for payment, and they tend to do so efficiently with sophisticated technological systems, but how productive can this be when you and your front office staff have done this on multiple occasions? They also have the option to place the debt on the debtor’s credit report. Again, this does not seem to be rather effective since the chances are that the debtor will already have multiple delinquent accounts and thus multiple creditors waiting for payment. In fact, about 

 have debt in collection, meaning that without an effective collections strategy, you’ll just be waiting in line behind other creditors for payment.

Collection law firms, on the other hand, have measures they can take in the legal realm to induce payment. The first call coming from an attorney representing you can indicate that you’re serious about receiving payment. From there, with your permission, the attorney can pursue a forbearance plan with the debtor, which would help both parties in avoiding the headache of going to court. However, if the individual is not complying with your efforts, the firm will file a lawsuit on your behalf and move to obtain a judgement in court. The judgement can be used to garnish wages, bank accounts, and tax returns; seize cars; lien property; and compel a debtor's appearance in court to satisfy a judgment. Collection agencies have the opportunity to use legal tools by contracting cases out to collection attorneys, and they sometimes do, but they often refuse to do so because it’ll mean that they’ll have to give up half their fee.

Another factor you must consider is which option will protect your firm from legal and ethical liability. Unfortunately, collection agencies have often been known for their legal errors and ethical transgressions, a reality that puts your firm at risk since they are acting on your behalf. Collection law firms understand the law and ensure they stay within its boundaries as they pursue payment on your behalf. They often even employ a compliance attorney in their office specifically dedicated to matters of liability. In these times where people’s ethical standards should be—and have been—heightened, you cannot afford blunders from those representing you.

Written employment contract updates for physician practices to consider

As time passes, your chances of collecting on a given account dwindles. In fact, on accounts that are more than 90 days overdue, the account is only worth 

. You really can’t afford to be slow to respond to this matter, as every day can count in the world of accounts receivable. Dealing with collections yourself can also be a serious burden on you, your staff, and operations, when you’d much rather be deploying your time and resources toward pursuing new clientele. Having a firm by your side you can rely not only to achieve superior results, but to also express proper legal caution and protect your firm’s image is critical. Collections law firms are more likely to deliver for you in collections and be a good steward of your reputation.

The differences between the two are important to note in your consideration of your collection strategy 

Collection Law Firms vs. Collection Agencies: What physicians need to consider

Existing challenges in addressing burnout have been exacerbated throughout the pandemic, Wayne Jonas, MD, says. We need to up our game in burnout prevention and management.

Why burnout remains an important topic during the pandemic

Two recently unsealed False Claims Act cases involving violations of material federal requirements provide a glimpse into areas that physicians and providers should be evaluating for continued compliance.

“Medicare is generally required… (for services covered under Part A … [and] for services covered under Part B) to pay for services furnished by providers on the basis of reasonable costs … 42 C.F.R. § 413.1 (2014)” There are of course requirements that need to be met. For example, 

Two recently unveiled cases provide a glimpse into areas physicians and providers should be evaluating for continued compliance.