March 15th 2024
Negotiating your payer contracts is the ticket to the money you deserve.
October 24th 2023
Payers are seeking to eliminate payments for care they deem unnecessary.
October 23rd 2023
These tips can make your next payer negotiation a bit more of a breeze.
October 3rd 2023
Consider these strategies to negotiate favorable payer contracts.
August 22nd 2023
They cost you a lot more than you think.
Debate: Should the ACA be Repealed or Restructured?
You've seen Trump vs Clinton. The Pearls podcast looks at another debate: Should the Affordable Care Act be repealed or not?
Survey Says Docs Dislike Gov’t Intrusion
The Great American Physician Survey reveals that doctors find their profession more stressful and less lucrative than in the past.
Practice Rounds: Anthem, Cigna Sniping at Each Other
As Anthem and Cigna aim to merge, reports say the two companies have been sniping at each other. Also, are fitness trackers effective in weight loss?
Inbox: Higher Deductibles Cramp Physicians, Patients
In our recurring blog "Inbox" we share comments from physicians and practice administrators telling us what keeps them awake at night.
The Problem with Team-Based Care
In an era of delivery and payment reform, with an imbalance of costs and savings in care, there are complex challenges behind team-based care.
Well-Child Exams and Payer Rules
Scheduling well-child exams in our practice has become a study in complexity, as we try to accommodate both payers and parents.
The Rising Cost of Patient Care
Small Practice Bears Larger Load for Healthcare Costs
Rising patient deductibles and cost sharing not only hurts patients, but also can put pressures on medical practices to manage their revenue cycle.
The Necessity of Physicians Banding Together
With so many clinical restrictions in healthcare right now, physicians and their medical expertise might just become redundant unless something is done.
Medicare's Sleight of Hand
Medicare's new payment program under MACRA will place pressure on independent physician practices, as they compete for limited Medicare bonuses.
5 Costly Processing Mistakes
Learning to avoid common and costly mistakes when accepting and processing card payments can add up to big savings for your medical practice. [Sponsored]
Many Changes Coming for Private Payers
Keeping up with the changes in the insurance industry right now is like herding cats. Here's what is on the horizon.
The Challenge of Providing Affordable Primary Care
Their practice was founded on the principle of affordable care for patients, while providing a good living for its owners. Now that dream is fading.
Practice Rounds: Physician-Owned Practices' Tech Costs Rise
New research from the MGMA indicates that physician-owned multispecialty practices are paying $32,500 per full-time physician for various IT expenses.
4 Payment Technologies to Put on Your Practice Radar
There are four payment technologies to put on your radar as you prioritize plans for upgrades or the installation of new technology. [Sponsored]
Physicians’ View of Meaningful Quality Metrics
How do physicians view meaningful quality metrics, as defined by CMS? Not favorably, according to one survey.
Fighting Back Against Insurer Recoupment Demands
Two lawyers share a way that healthcare providers can challenge insurer recoupments in the ongoing struggle with payers relating to provider reimbursement.
Practice Rounds: Anthem Defends Merger with Cigna
Despite resistance from providers, patients, and the DOJ, Anthem is not giving up on merging with Cigna. Plus, CMS hands out star ratings.
Supreme Court Issues False Claims Act Opinion
Stricter government standards for the FCA suggest that physicians who do not meet all measures of compliance could be required to refund claims payment.
Is the Cost of Obamacare Too Great?
Healthcare reform promises to improve care, reduce cost, and afford more people access to care. But at what cost will those goals come?
Audit Your Medical Practice's Third-Party Vendors
When using third-party vendors for certain practice functions, it's always wise to take a close look at their performance.
Practice Rounds: CMS Opens Door for MACRA Delay
Could a delay to the start of MACRA be in the works? Also, what makes radiology a unique specialty when it comes to physician pay?
Analyzing the Black-White Pay Disparity in Medicine
In this edition of the Physicians Practice Pearls Podcast, we speak with Anupam Jena, a researcher who studied the pay disparity between black and white physicians. Why do black physicians earn significantly less?
MACRA, MIPS, and APMs - Are You Ready?
Successfully participating in MIPS or an APM will depend on meeting new measures and thresholds. Here are six key points to consider.
How The 60-Day Repayment Rule Will Impact You
The 60-Day Rule, which forces physicians to return overpayments to CMS, was recently clarified. What should physicians know about it?
Practice Rounds: No Healthcare Privacy for Young Adults
Despite HIPAA protections, young adults still on parents' health policies have little privacy. In some states, that is beginning to change.
The Inbox: Physicians Are Steamed When It Comes to Burnout
Eliminating Red Tape is a Physician's Top Wish
If most doctors got three wishes from a genie, what would they be? This doctor says that he only needs one and it involves red tape.
Practice Rounds: HHS to Aid Small Practices with MACRA
HHS is giving $100 million to help small practices implement MACRA over five years; Zika relief funding faces hurdles in Congress.
Making the Case for Direct Primary Care
M. Samir Qamar, a family medicine physician, made the switch to direct primary care a few years back and hasn't looked back. He explains why he loves it.