Proper, adequate coding and documentation have become an increasingly important aspect of modern medicine, especially with the prevalence of electronic health records (EHR). While electronic records provide some documentation benefits to the physician, such as legibility and ease of inter-physician communication, they also carry potential coding risks. Many EHR systems automatically calculate the level of […]
Just like when you bill to the private third-party payer, billers must send claims to Medicare and Medicaid. These claims are very similar to the claims you’d send to a private third-party payer, with a few notable exceptions. When you claim for Medicare and Medicaid, there is no need to go through a clearinghouse for […]
The pressure on hospitals to improve patient care at lower costs is not new—and it’s not going away. Technology has never been more of a priority than it is right now for healthcare providers, especially as the industry continues to shift from fee-for-service to value-based care models. Hospital leaders are juggling a growing slate of […]
Revenue cycle management (RCM) for dermatology is undergoing a significant transformation. Practices are better understanding the impact of people. With the help of processes and technology, you can improve the performance of the dermatology revenue cycle with increased cash flow. Physicians, staff, and patients can be frustrated if a physician’s office processes run inefficiently. This […]
As a physician, you start growing in your practice you will realize that you need to outsource part or all your billing routine tasks to be more productive and efficient at work. HIPAA compliance is not really an option. All medical practices and businesses must be compliant to stay in business. What Is HIPAA? Health […]
Cancer patients admitted to an emergency or intensive care unit (ICU) have some critical requirement of basic care needs because of their unknown illness; time-point in the treatment plan and treatment-related deadliness resulting in organ damage, hemodynamic infection, or blood contamination. Over the past two decades, therapeutic advances have reshaped not just the medical approach […]
In an old-fashioned practice model, the physician is solely responsible for most, if not all of the work undertaking of his facility, which also involves charge entry, to medical billing and coding till the time of claims reimbursements. Sharing the workload With the team care model, however, the physician and clinical assistant share these responsibilities. […]
CMS released the proposed Outpatient Prospective Payment System – OPPS rule for 2018— which includes a major proposed cut for separately payable drugs purchased under the 340B program. The proposal would reduce reimbursement for separately payable Medicare Part B drugs purchased at 340B prices. Reimbursement would drop from average sales price plus 6% to ASP […]
The Center for Medicare and Medicaid Services (CMS) proposed a new rule that will update the payment policies and rates. The update will specifically cater to Hospital Outpatient and Ambulatory Surgical Centers (ASC). The rules will set forth a motion to promote efficient service and promote higher quality service for all the Medicare beneficiaries. The […]
The family practice is an intermediate between the patient and a specialty doctor. As most family practice doctors today grapple with the complexities of billing and regulations, finding an easy solution remains elusive. Managing different situations at a family practice is becoming a growing concern, especially as specialists prepare for real-life healthcare challenges. Increasing workplace […]
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