April 24th 2024
The crux of payer-provider collaboration lies in alignment.
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.
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.
Decoding PA Reimbursement Guidelines
Confused over how PAs get reimbursed in the healthcare system? Here are a few guidelines to help you out.
Kicked Out of a Preferred Provider Network? Here's Help
More administrators are threatening to kick providers out of a preferred provider network. Here's tips on how to avoid this fate.
What to Look for in an RCM Partner
Wrongful Payer Denials: How to Handle Them Quickly
When you are wrongfully denied for a single code or entire claim, do you know what to do?
What to Know about Claims Audits from Payers
Insurance plans are using the audit process to recoup payments for services which were preauthorized, based on charting. What should practices know?
Medicare Denies Coverage of Certain PET Scans
A recent change to Medicare reimbursement of PET scans shows why physicians need to stay abreast of this kind of information.
Trust and Accountability Key to Outsourcing RCM
If you think you can just outsource revenue cycle management and walk away, think again. Here are five tips to ensuring a successful partnership.
Economic Pressures Bolster Case for Outsourcing Billing
While many practices are reining in expenses, it may make sense to outsource revenue cycle management as a way to improve your bottom line.
Physicians, Administrators Share 2016 Resolutions
We asked physicians and administrators what their resolutions were for 2016, either personal or professional. Here's what they said.
Overcome Exchange Health Plan Payment Challenges
Practices must explore new collection strategies for patients with high-deductible plans that require more financial responsibility.
Putting Patients First Before Insurance Companies
Training staff to follow payer policies makes sense, but what happens when that negatively affects patient care?
CMS Should Adopt a Flat Rate for E&M Office Visits
Many physicians feel that useless chart documentation has grown to consume most of the patient visit, leaving little time for patient care.
Physicians Must Realign Compensation with Value
Value-based reimbursement isn't the future for physicians; it's here. It's time to tie quality outcomes to compensation.
Quality Programs Physicians Should Heed
Do yourself a favor: participate in as many quality programs as make sense for your practice.
2015 Physician Compensation Survey Results
Obesity: An American Epidemic
It is predicted that 50 percent of Americans will be obese by the year 2030. It is time to increase public awareness and research into this disease.
ICD-10 is Here: Now What?
The big bang of ICD-10 has happened. Practices should focus on getting reimbursement from third-party payers and clearing up any issues.
Employed Physicians, Protect Yourself from ‘Clawback’
What is “clawback” language? It can be used by employers to make physicians recoup demands from federal and private payers.
Using SOAP Notes for Business Problems
Practitioners are used to applying SOAP notes to clinical problems, but they can be used effectively for business issues as well.
Physicians Contract with Self-Funded Employers
Some medical practices are cutting out insurance companies and providing services directly to employers, thereby reducing overhead and cost to patients.
Our Patients Are Paralyzed by Choice
Providing patients with too many options may not help them at all. Without adequate resources to make well-informed decisions, they may just feel angry.
What to Tell Patients About Open Enrollment
With the healthcare exchange open enrollment period starting Nov. 1, educating your patients about the facts is vital.
Patient Pricing Transparency Movement Hits Stride
Practices are going to have to accept pricing transparency experts say, otherwise they'll get left behind as consumers push this trend forward.
Don't Let ICD-10 Consume Your Every Moment
With the rollout of ICD-10 it's important to keep a sense of normalcy in other critical areas of your practice. Here are some ways to do that.
Helping Patients Understand Insurance Benefits is Key
Helping patients manage multiple insurance plans with convoluted rules will improve their ultimate care, and also benefit your practice.
Becoming a Patient-Centered Medical Home
After a lengthy transition, one multispecialty medical practice is reaping the benefits of NCQA recognition as a PCMH.
Understanding Health Insurance Costs
Helping patients understand they have to pay for their care can be difficult. Here’s a guide that helps break it down.
Deal or No Deal: Getting Medical Payers to Pay
Medical billers can feel like game-show contestants when trying to collect payment from insurance companies.
Five Steps for Elevating Medical Practice Operations
This survival guide offers key activities to move a practice beyond reactive management and toward a proactive approach to optimize performance.