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
Assess Your Payer Contracts
This simple work sheet will let you compare your payers' reimbursement for specific procedure with your costs for each procedure. If you're spending more to provide a service than you're making for it, then it's time to address the problem.
Evaluate Your Payer Mix
Use this easy calculator to find out which of your payers are worth your efforts. By comparing the percentage of revenue to the percentage of patient encounters for each of your payers, you can tell at a glance which plans are the poor performers.
Refer to Collections Form
Physicians often want to review an overdue patient account before it is sent to a collection agency. Staff can use this form to summarize the status of the account, making review easier.
Documentation Template - General
Use this sample template for guidelines on documenting patient visits in general. Provided by Hill & Associates.
Modifier Manual
Plain language advice on using common modifiers in your medical coding.
Payment Coupons for Patients
Take a page from your mortgage company. Instead of sending self-pay patients on a payment plan statements every month, give them coupons.
Collections Letter 1
This is the first in a series of letters to use for patient collections.
Documentation Template - Established Patient
Use this sample template for guidelines on documenting established patient visits. Provided by Hill & Associates.
Financial Policy
Let new patients know about your policies from the get go. Follow these guidelines.
Referral Waiver
Specialists, use this waiver if a patient forgot his referral. It says that the patient agrees to pay for services rendered that are not covered by his managed care company.
Documentation Template - Outpatient
Use this sample template for guidelines on documenting outpatient visits. Provided by Hill & Associates.
What’s Your Profile?
Executive editor Bob Keaveney speaks out against the pervasive practice of cost-profiling physicians.
Payer Performance Examined
Our fifth edition of PayerView uses real claims data to examine and rank payers based on financial and administrative performance, as well as efficiency. Here’s to friendly competition that helps docs get paid.
Preparing for RAC Audits
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.
‘My Most Frustrating Patient’
Plastic surgeon Eugene J. Strasser runs into trouble when an angry patient insists he bill Medicare for an elective procedure and he rightly refuses.
Solving Your 9 Biggest Billing Blunders
Coding is hard. It’s tedious. Yet it is how you get paid for the services you perform. So we asked the experts where things go wrong most of the time - and how to fix them.
Playing Hardball with Payers
Knowledge is power in the payer game. Expert Lucien Roberts explains how to evaluate your payers and then use that information to negotiate better reimbursements.
Medicare’s New Bounty Hunters
Concerned about Medicare’s new Recovery Audit Contractors snooping around? Though your practice may not be affected by RACs for at least a year, the time to ready your defenses is now. Here’s how.
Payer Take-backs, Take That!
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.
Outsourcing Your Billing
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.
2009 Fee Schedule Survey: Survive the Perfect Storm
A lingering recession and declining reimbursement make for stormy weather for practices. Check out our suggestions for how to stay dry - and in the black.
Payment Bundling: Like It or Not, It’s Coming
Hospital-doctor bundling schemes are a near-certainty in any healthcare reform. Will physicians get the short end of the stick?
Making Sense of Productivity - Using RVUs
The best measure of physician productivity is the “relative value unit,” or RVU. But a physician trying to figure out how much she’ll be paid under this system doesn’t know where to start, or even what an RVU is. Here’s help.
Billing Service or EHR Vendor?
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?
Climbing Out of the 99213 Rut
Here's how to properly use E&M code 99213, including when other CPT options might be more appropriate with patients at your medical practice.
Smart Patient ID Cards Could Save You Money
Say goodbye to photocopies: Machine-readable cards could make billing and collections easier. When will payers make them widely available?
Ready for Medicare's Audit Police?
Medicare hopes to save millions with tougher billing rules and aggressive audits - changes that could cost your practice money. But if you bill right and on time, you can keep that Medicare check coming.
PayerView - The Best and Worst Payers Revealed
Which payers should you deal with and which should you drop? PayerView uses real claims data to rank them first to worst.
Assignment of Benefits
Appeal Letter for Prompt Payment
Appeal letter for prompt payment from your medical practice payers.