RCM Strategies to Improve Practice Revenue

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. […]

Avoiding Coding Audits

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, […]

Managing Medical Records while Closing or Relocating Practice

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 […]

Managing Patient Payments Challenges

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 […]

Importance of Retaining Medical Records

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 […]

Providing Complete Clinical Information to Radiologists

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 Guidelines for Telehealthcare

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 […]

Keeping Patient Credit Card Details Safe

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. […]

Understanding Medicare Recovery Audit Contractor (RAC) Audit

What is Recovery Audit Contractor (RAC) Audit? As a combined effort to fight fraud, waste, and abuse in the Medicare program, Recovery Audit Contractor (RAC) audit was in place from January 1, 2010. The goal of the recovery audit contractor program is to identify improper payments made on claims for services provided to Medicare beneficiaries. […]

Understanding PAR and non-PAR Providers with Medicare

PAR and non-PAR Providers with Medicare The Center for Medicare & Medicaid Services (CMS) is a federal agency within the Department of Health and Human Services which manages and oversees the Medicare program for beneficiaries. Physicians are required to comply with numerous laws and regulations related to various aspects of their practice within the Medicare […]

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