Collect More Accurately with Eligibility and Benefits Verification

Eligibility and benefits verification is the first and most significant step in the medical billing and coding process. Today’s continually changing and increasingly complex healthcare environment requires, more than ever, close attention to validating coverage, benefits, co-payments, and unpaid deductibles. With the eligibility and benefits verification process in place, you can collect more accurately. Thus, […]

How Can You Fix Expensive Medical Billing Mistakes?

Sometimes, you are so focused on delivering the best patient care, it causes key medical billing mistakes. Whether it’s submitting paper claims, not having EOBs for all claims, not understanding denial reasons, not following up on claims, not reviewing clearinghouse reports, and the list goes on. Unfortunately, failure to follow payer policies and reimbursement guidelines […]

Charging Patient No-Shows

Despite your best efforts to remind patients of their appointments, you’re still likely to encounter one or two patient no-shows every day, approximately 5 percent to 7 percent of total monthly appointments. If the average office visit generates a $25 co-pay and a $90 reimbursement, just two missed appointments per day can cost your practice […]

Removing Front Desk Inefficiencies in a Medical Practice

Inefficiencies in medical practice not only waste time and effort, but also contribute to errors, reduce productivity, affect practice revenue, and frustrate patients, staff, and providers. Despite the potential for serious consequences, many practices fail to address these inefficiencies. Perhaps practice owners don’t have skilled manpower to handle such inefficiencies or they can’t take sufficient […]

Preparing Your Practice for Telehealth Services

Telehealth is gaining popularity daily. The COVID-19 pandemic endorsed the importance of virtual care. Telehealth has received acceptance and more confidence from patients not only for counseling but for other medical services too. If you are not offering telehealth services then you might be missing greater opportunities. Offering telehealth services requires little preparation. Preparing your […]

Keeping Your Practice Profitable During Pandemic

Maximizing profitability and practice collections is the main objective for successful medical practices. In a time of this pandemic, however, practice profitability became even more critical. Your practice’s profitability depends on a variety of factors that aren’t always under your control, particularly during times of crisis. But rather than looking at this pandemic situation as […]

Reducing Medical Billing Staff Burnout

According to MGMA’s (Medical Group Management Association) report, amongst the COVID-19 pandemic, burnout among medical billing staff becomes an overwhelming problem. MGMA reported a combined 30% turnover rate specifically among front office and operational staff, the highest of any other healthcare career category. Continuously changing payer policies and reimbursement guidelines put additional pressure on medical […]

Proposed Changes to Shared Visit Billing

Basics of Shared Visit Nurse practitioners (NPs) or physician assistants/physician associates (PAs) and physicians sometimes ‘share; patient visits. A shared visit which is also called a split visit is one where both types of clinicians participate in evaluating and managing a patient on a given day. The Centers for Medicare & Medicaid Services (CMS) defined […]

Basics of Value-Based Contract (VBC)

Defining Value-Based Contract (VBC) A value-based contract (VBC) is a written contractual arrangement between parties in which the payment for health care goods and services is tied to predetermined, mutually agreed upon terms that are based on clinical circumstances, patient outcomes, and other specified measures of the appropriateness and effectiveness of the services rendered. In […]

Avoiding Healthcare Fraud and Abuse

Providers face multiple healthcare fraud and abuse laws at the local, state, and federal levels. Fraud and abuse cases in the healthcare industry cost billions of dollars a year. Healthcare fraud and abuse situations include submitting false claims; billing for medically unnecessary services; billing and coding errors; billing for services that were provided by unlicensed […]

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