Timely collection of patient payments is equally important as collecting insurance reimbursements. In the past few years as more and more patients are adopting High Deductible Health Plans (HDHPs), patient responsibility has increased exponentially. The most reliable source of patient collections is when they are in the office. So, up-front collection of patient payments at […]
Differentiating Between Medical Necessity and Medical Decision Making Medical coders and physicians often confuse between terms medical necessity and medical decision making and this confusion might lead to an inaccurate selection of Evaluation and Management (E/M) codes. It’s important to understand both concepts and clear the confusion as it could result in denied payments. Any […]
What is ‘Insurance Only’ Billing? As the name suggests, in ‘Insurance Only’ billing, healthcare practices accept the amount the insurance company will pay and waive patient responsibility portions like co-pay, coinsurance, and deductible amounts. In most circumstances, this puts the physicians and the practices in jeopardy, especially when your client base is Medicare patients. Medicare […]
Forming group practice can be incredibly rewarding, from both a business and a financial standpoint. By starting a group practice, you have the opportunity to create a work atmosphere that allows healthcare providers to thrive, be cared for, and feel good about the work they do. Building, growing, and managing a group practice requires a […]
Basics of Healthcare Audits In the healthcare space, audits play a crucial role in measuring compliance and patient satisfaction. There are two main types of healthcare audits that providers face, internal audits and external audits. External audits can be broken down further into government and commercial insurance audits. From there, government audits can be broken […]
It’s Hard to Sell Your Practice Selling a healthcare practice could be difficult a process. Key challenges in selling your practice include finding the right buyer, wading through legal and financial complications, and handling clinical matters. Coupled with a lack of knowledge about the process, some healthcare providers can be discouraged from selling their practice […]
Appropriate level of Evaluation and Management (E/M) services are based on Medical Decision Making (MDM) and time for services performed. In our previous article, we has a detailed discussion on how Medical Decision Making (MDM) affects E/M code selection and other factors involved. In this article, we will be focussing on guidelines for the selection […]
Challenges of Running Solo Practice If you are a solo healthcare provider or own a small medical practice, you might sometime feel the pressure of having to do everything on your own and struggling to provide optimal patient care. Running a healthcare practice offers unique challenges like administrative and insurance tasks, government and insurance regulations, […]
Medical Billing Challenges for Group Practices Group practice owners face an unprecedented number of challenges today, from adding or replacing providers; getting rendering providers enrolled; adopting new technologies; up to receiving an accurate reimbursement for delivered services. Any group practice’s success is reliant on strong Revenue Cycle Management (RCM) team, error-free & timely claim submissions, […]
After COVID-19, providers are now ready to provide excellent patient care through direct and virtual modes. Medical billing has always offered unique medical billing challenges prior and post-pandemic. Due to the changed billing environment post-pandemic, this struggle to receive accurate reimbursement has become more real than ever. As a leading medical billing company, Medical Billers and […]
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