Many practitioners have difficulty being paid for Transitional Care Management (TCM) services. In many cases, claims submitted for TCM services have not been paid due to several common errors in claim submission. In particular, the practitioner should ensure that the entire 30-day TCM service was furnished, the service began with a qualified discharge from a […]
One of the common reasons medical claims may be denied is for missing modifiers or invalid modifier combinations. Accurate coding of treatment is essential, but it’s also important to ensure you include modifiers when necessary and ensure you’ve used the correct one for the code you’re using. When your claim is denied, it not only […]
Your medical practice revenue is driven, impacted, and influenced by Revenue Cycle Management (RCM) strategies. It includes claims management, patient payments, and your in-house billing workflow. Without implementing these strategies, providers might find it difficult to maintain high levels of clean claims, adjust to an increasing dependence on patient payments, or manage their billing effectively. […]
Government and private payers conduct audits to find out fraudulent or abusive medical billing practices. As a provider, you deserve to be paid accurately for the medical care you provide. At the same time, it’s essential that you avoid improper billing practices to steer clear of trouble and maintain a flourishing practice. In this article, […]
The decision to close or relocate a medical practice can be a difficult one, with consequences for patients as well as for the departing physician’s colleagues. Physician practices close or relocate for many reasons, including practice solo, joining another group, relocating, a decision to sell, retire, physician illness, due to the COVID-19 pandemic. Whether you […]
With more patients opting for High Deductible Health Plans (HDHP), the total percentage of patient payments has increased significantly in the last few years. A recent survey report regarding healthcare payment patterns reveals that about 35 percent of provider revenue comes from patient pay. Timely collection of patient payments is the key to the financial […]
The most important reason for retaining medical records is to share information on a patient’s care with other healthcare professionals. The COVID-19 pandemic and increased inpatient telehealth services have emphasized the importance of retaining complete and accurate records. Retaining well-maintained patient records helps medical professionals ensure continuity of care and protect against any future professional […]
It is not uncommon for radiologists to receive inadequate patient information that potentially compromises their diagnostic decision-making abilities and accuracy. The recent evidence-based study has shown that communication of clinical information to the radiologist, including patient complaints and indications for the imaging request, is required for a quality radiology interpretation process and for making recommendations. […]
Documentation requirements for telehealthcare are identical to those of onsite medical care. Documentation plays a significant role in establishing medical necessity for billing; adhering to regulatory compliance; and supporting your claim in case of internal and external audits. Documentation rules may change as per insurance carrier’s contracts outlining medical necessity expectations and state regulations that […]
A recent survey report regarding healthcare payment patterns reveals that, out of total patient payments, 73 percent of payments took almost a months’ time. While 12 percent of patients’ outstanding took more than 3 months to get paid. The same survey report also suggested that about 35 percent of provider revenue comes from patient pay. […]
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