Reimbursement Cuts: Texas Doctors Using Personal Resources

Small private practices struggle to survive, even as Texas Medical Association (TMA) President reported a significant worsening of the practice environment with various physicians using money from their personal reserves or secured bank loans to keep their practices going. According to AMA news nearly 51% of Texas doctors dug into personal funds. Various national reports […]

States Mimicking Medicare – Experimenting with Accountable Care Models for Medicaid

Accountable Care Organizations (ACO) model’s popularity is growing and mirroring Medicare almost 11 states are trying ACO models for their Medicaid programs by adding initiatives resembling ACO’s to their programs, moreover various providers who initially were vary of Medicare ACO models are showing interest in the state versions as well. With the exact number of […]

Hospital EHR Payments Doubled in the Last Quarter Exceeding $1.9 Billion

Hospital payments escalated to more than double from October through December 2011 exceeding $1.9 billion, through the Medicare and Medicaid electronic health-record (EHR) system incentive programs, as reported by CMS’s latest monthly report. Both physicians and other eligible professional’s payments also increased 99% during the same period to nearly $570.4 million. According to CMS the […]

Analyzing Revenue Management Techniques for Ophthalmologists

“While Ophthalmologists seek to reinvent their clinical and operational model, the booming prospect of patient influx – 43 million by the year 2020 comprising age-related eye diseases, including cataracts, diabetic retinopathy, glaucoma and age-related macular degeneration– should also be encouraging to their hearts. But, the issue of realigning their clinical and operational model to the […]

Physician Bundle Payment Plans: Improving Claims Generation

Healthcare is costly in general and what makes it more prone to increase in costs is that it comes in phases: pre-hospitalization, hospitalization and post-hospitalization. To address the situation and provide patients with an all-encompassing payment package, many payment modules have been tried out over the years across all states of the US. But the […]

Balancing ACO Objective with Physician Reimbursement Maximization

As the U.S. healthcare sector looks up the Accountable Care Organization (ACO) Concept of healthcare delivery with great expectation, physician community is quite apprehensive about their ability to garner reimbursements under a new healthcare delivery altogether. While ACO itself is not a novel concept – there have been umpteen examples of institutions operating on ACO […]

Upfront Realization as the catalyst for accelerating Physician reimbursement

“As physicians juggle with their core medical focus and issues related Upfront Collections, there would eventually be an adverse impact on their ability to afford quality medical care. Therefore, sooner or later, they would have to decide on outsourcing the competent services that can offer the best upfront Collection as part of the comprehensive Revenue […]

Seeking Possible Solution to Intensifying Medical Billing Documentation

“Beset with spiraling Medicare expenditure amidst a rather volatile economy, the Federal Government policy of linking physician reimbursement to quality outcomes will not only test physicians’ level of quality medical care but also how they are going to document patient encounters. Therefore, physicians, required to furnish evidence-based healthcare documenting & reporting, will find it hard […]

In Retrospection: Revenue Collection Accomplishments in 2011

“While these comprehensive measures are no doubt indispensable to optimizing healthcare overheads and expenditure, physicians’ task to get their bills reimbursed could get even tougher, thereby making sustenance and growth prospects equally competitive. Although they have had, by and large, a prosperous year revenue-wise, the ensuing financial year evokes an air of apprehension. But, amidst […]

Medical Coding: from ambiguity to certainty

“As we try to analyze the staggering impact of approximated coding and deciphering, the ensuing ICD-10 with over 150,000 codes, the Systematized Nomenclature for Medicine (SNOMED) with over 11 axes for accommodating comprehensive list of codes, and the HIPAA 5010 Compliance for Medical Reporting should come as much the needed relief for the vested interests […]