Denials

Recovery Audit Contractor (RAC) is a term that every Medicare healthcare professional and staff member needs to know.

Considering outsourcing the business side of your practice to a revenue cycle management firm? Let someone deal with the claims and collections headaches … right? Maybe. We examine the pros, cons, expenses, and benefits.

Social networking is all the rage, but be wary if your staff are posting updates to Facebook. Setting a few ground rules can help avoid damage to your practice.

There are many intangibles to consider before sitting at the table with a payer to negotiate reimbursement.

Payers have been investing heavily in technology to help manage data and keep their costs to a minimum.

You’ve got questions - lots of ’em. And we’ve got the answers. We compiled some of the most common practice management questions we hear - from collections issues to dealing with staff problems and so much more - in one place, and got answers from some of the top experts in the business.

EHR companies are increasingly offering billing services, and vice versa. Is this just another way to squeeze money out of you, or does it make sense to combine the services?

Payer requests for refunds for incorrectly processed claims are endemic. But wait! There are some things you can do before you write that check.

Say goodbye to photocopies: Machine-readable cards could make billing and collections easier. When will payers make them widely available?

Which payers should you deal with and which should you drop? PayerView uses real claims data to rank them first to worst.

Appeal Letter for Claims Denied for Improper Bundling

Appeal Letter Justifying Emergency Treatment

Appeal Letter Justifying Medical Neccessity

Use this letter when a claim is denied because a patient saw a physician in your group who is not his or her designated primary care physician.

This Advance Beneficiary Notice form, created by CMS, is best managed by the clinical team at your medical practice versus the front office staff.

If you’ve been putting off developing a compliance procedure for the new Red Flags Rule aimed at preventing identity theft, the time has come to act.

Following a two-year demonstration project in four states, Medicare’s Recovery Audit Contractor (RAC) program is going nationwide in 2009.

This month: Office vs. hospital outpatients; 2009 surgical global package; When to code a consult.

Outsourcing billing operations can be a relief to a frazzled practice. But you need to do it right; after all, your practice’s revenue is at stake.

Coding is no fun, but you gotta get it right if you wanna get paid. Here’s our guide to coding like a pro.