Billing Company Should Be Sharing Monthly Reports with You Regularly

As a physician, you need a reliable and efficient business intelligence system that provides automated revenue reports of your practice. These reports will provide you with accurate information regarding the health of your practice saving you from lost revenue, keeping your practice financially sound while allowing you to free up your clinical staff and resources […]

Accounts Receivable: How to Read a Complicated AR Report Very Easily?

Medical billing reports are a key barometer for understanding what’s going on in your medical practice. Without good reporting, it’s difficult to determine whether your practice is making money or not. Monthly reports can show you how your medical practice is performing on important revenue cycle metrics, whether claims are being paid in a timely […]

What is an Ideal Denial Percentage?

Ideal Denial Percentage What is an ideal denial percentage? Yes, there will always be some denials A denial rate demonstrates the percentage of claims that payers deny within a certain period of time. This often-overlooked percentage offers a tangible numeric insight into the overall effectiveness of revenue cycle management. The denial rate represents the percentage […]

Received Payer Request for Medical Records? Keep Calm and Take These Steps

If a letter were to arrive at your organization in an innocuous-appearing envelope, you may be afraid to open it. It’s unsettling for a payer to request medical records for claims that have already been paid. It is becoming more and more common for providers to receive what appear to be innocuous medical records requests […]

Understand Payment Rates and Basics of ASC Billing

Basics of ASC Billing The Basics of ASC billing encompass the financial processes associated with Ambulatory Surgical Centers (ASCs). CMS defines an Ambulatory Surgical Center (ASC) as a facility that provides outpatient surgical services to patients. ASC is a facility that, very simply, specializes in outpatient procedures. Procedures at an ASC are more extensive than […]

What is MIPS and How it Affects My Practice?

What is MIPS? On November 1, 2018, CMS released revisions to payment policies under the Medicare Part B physician fee schedule for the Quality Payment Program (QPP) for the calendar year 2019. In accordance with one of the most bipartisan and significant legislative changes to Medicare in a generation, the Medicare Access and CHIP Reauthorization […]

Understand Basics of Optometry E/M Coding

Typically, eye care practitioners don’t use the E/M codes for what most Optometry service considers a general eye examination. They are more typically used for patient encounters where the patient presents with a medical complaint or a continuation of medical case management (i.e., glaucoma, allergy, dry eye). The five levels of E/M codes are universally […]

Common Denials for SNF and How to Avoid Them?

Denial 1: Certification or Recertification Statement (Missing/ Lacked Information) From 2012-2014 the percentage rate of improper payments to SNF almost doubled all stemming from failure to obtain certification or recertification. General Guidelines: The Certification Statement must include that the individual requires skilled nursing (furnished directly by or requiring supervision of skilled nursing personnel) or skilled […]

Top 3 Radiology Claims Denials and How to Avoid Them?

The goal of a well-managed radiology billing operation is to submit claims for services promptly and receive reimbursement as quickly as possible. Timely submission and prompt payment enhance the practice’s cash flow and keep the overall cost of billing at a minimum. All too often, however, payment is delayed because the payer denies the claim […]

Top 5 Compliance Issues for Ambulance Biller

Ambulance service billing involves a host of unique compliance challenges. The ambulance industry has seen a significant number of false claim cases, fraud investigations, Medicare audit activity, and other types of billing-related cases. It is imperative that billers fully understand the nuances of ambulance reimbursement to be able to successfully sidestep these landmines. The following […]

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