There are two main categories of services for which a physician may not be paid by Medicare: Services not deemed medically reasonable and necessary Non-covered services In some instances, Medicare rules allow a physician to bill the patient for services in these categories. Understanding these rules and how to use them in your practice increases […]
Creating medical billing reports can help you diagnose the health of your practice. Reports can show you how your practice is performing on important revenue cycle metrics, whether claims are being paid in a timely fashion and how well insurance carriers are paying you for key procedures, among other things. These reports will provide you […]
Since family practices face many factors that make getting paid more challenging, getting proactive about billing procedures is more important than ever. Being proactive and preventing problems before they occur can help your family practice maximize revenue, ensuring you’re adequately reimbursed so your practice can continue providing quality patient care. Every year, medical providers in […]
Accounts receivable or AR is a term used to denote money owed to your practice for services you have rendered and billed. Any payments due from patients, payers, or other guarantors are considered AR. An increase in AR from one period to another is often a sign that monies such as copays, deductibles are not […]
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 […]
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 […]
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 […]
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 […]
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? 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 […]
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