April 9th 2024
It’s clear the state of PA must change. Artificial intelligence has a role in streamlining administrative tasks.
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.
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.
The Inbox: Offsetting Declining Practice Revenue
In our recurring blog "Inbox" we share comments from physicians and practice administrators telling us what keeps them awake at night.
California Opposes Anthem-Cigna Merger
With the California Insurance Commissioner recommending the DOJ block the Anthem-Cigna merger, it seems that patients are finally being put first.
The Over-Regulated Healthcare Marketplace
Many physicians are considering a private care model in response to growing pains stemming from healthcare reform. But how long can they function without oversight?
Have Docs Fill Out Conflict of Interest Questionnaires
Your practice's physicians may hate filling out those conflict of interest questionnaires, but they are important in complying with the federal Stark Law.
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?
The Inbox: Physician Deliberations on MACRA
HHS Overpayment Recoupment Sends a Flag to Physicians
A recent ruling from the U.S. Court of Appeals emphasizes why it's important for physicians to not cut corners.
Educating Patients on Health Insurance Benefits
Spending a few minutes explaining health insurance benefits to patients prior to the appointment should become a requirement.
Starting a New Journey in Medicine
Dr. Rebecca Fox talks about her new practice and the next steps in her healthcare journey.
Small Practice Doc Speaks Out Against MACRA
In this Q&A, a family medicine doc talks about why the MACRA legislation should terrify small practice physicians from a financial perspective.
The Frustratingly High Cost of Medication
One doctor commiserates on the fact that drugs can be incredibly expensive, forcing her patients to choose between medications and paying rent.
MACRA to Hit Small Practices Hard
What to know about the proposed rule on MACRA implementation from CMS, including how financially damaging it will be to solo and small practices.
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?
Reviewing Payer Websites Shows Outdated Information
Medical practices must make it a point to periodically review payer websites and make sure that their information is correct.
Three Strategies to Pay Off Medical School Debt
It’s hard enough as private practice doc in today’s reimbursement environment. Medical school debt can make it worse, here are tips to avoid this issue.
Decoding PA Reimbursement Guidelines for Medicare
A guide to helping physicians better understand the process of Medicare-based reimbursement for PAs. What do you have to know?
Marketing Company Indicted in $65M TRICARE Fraud
The personal services safe harbor law exists to protect physicians from prosecution when they receive payments for legitimate services.
Four Things to Know About the 2016 OIG Work Plan
When Payers Try to Recoup Funds
Private payers are finding fraud and abuse as a way to recoup funds they say were wrongly paid. Here's how to respond to these requests.
Simple Medicare Enrollment through PECOS
Enrolling or revalidating clinical staff in Medicare just became much easier for this billing services provider.
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.
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.
Donate to a Pharma Executive in Need
The price of that prescription might be weighing on your patients' minds, but let them know that by accepting it, they are helping someone in "need."
New Jersey Healthcare Plan Favors State Employees over Taxpayers
New Jersey is already a primary-care physician shortage area. A new state plan makes the problem worse by giving state employees special status.
Bundled Payments and Concierge Care
A new Medicare initiative will reimburse physicians for episodes of care, rather than individual procedures. A hybrid concierge model could preserve income.
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?
2015 Fee Schedule Survey Results
Taking the Lead with Insurance Companies
By having an exact plan of action in place, your company will suffer less from insurance company abuse and mistreatment, and you'll be managing them, instead of them managing you.