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Author: Medical Business Management

MACRA: An Introduction

Physicians spent years trying to get Congress to repeal the Sustainable Growth Rate (SGR) formula, which made adjustments to physician reimbursement based on shifts in Gross Domestic Product – and, over time, resulted in massive payment cuts to doctors. After a lot of patching and ho-humming about the situation, Congress finally repealed the SGR formula […]

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Why Is Medical Billing So Hard for My Practice?

For any practice, medical billing is a time-consuming, often confusing process with ample room for error and rules that change regularly. Here, we’ll look at three reasons medical billing is so difficult to keep up with. Reason #1: Ever-Changing Rules One of the main frustrations of medical billing is that the rules always seem to […]

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The ABCs of Anesthesia Billing

Anesthesia billing can be hard to understand -- and even harder to keep up with. From revenue cycle management to coding, it’s almost inevitable that something will fall through the cracks (unless you hire a third-party company to handle it for you, of course). Here, we’ve broken down the anesthesia billing process into three components […]

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What Is the Federal False Claims Act?

The Federal False Claims Act places civil liability on practices that knowingly submit, or cause the submission of, a fraudulent or false claim. What could happen if your practice were found guilty of such an action? Keep reading to find out. Penalties Under the Federal False Claims Act Obviously, penalties abound for filing false or […]

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The Importance of Patient Assessments Before Anesthesia

It’s a more common issue than we realize: medical professionals are sometimes asked to provide anesthesia for a patient without any knowledge of that patient’s medical history or current physical condition. A thorough evaluation of the patient’s health history, current physical condition, and psychological state before administering anesthesia is a necessity. This has always been […]

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The Diverse Effect of Obamacare

For the fourth consecutive year, fewer Americans are reportedly having a hard time with their medical billing situation. This comes from a report done by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). The study was done by NCHS researchers Jeannine Schiller, M.P.H. and Robin Cohen, PhD. What does […]

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Here Is a Five-Step Process for Better Cash Reconciliation

All medical practices have issues with managing patient accounts receivables (AR) and cash reconciliation. It’s not endemic to just one specialty. And while some practices are better at revenue cycle management than others, all run into problems eventually. Earlier this month, we talked about creating a better reconciliation process. In this post, we’ll give you […]

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How Your Practice Can Deal with Upcoding and Downcoding

Part of running a successful medical practice is navigating the complicated world of medical coding and billing. Doing so means understanding obstacles – both foreseen and unforeseen – and overcoming them with proven solutions.   Two problems with medical billing and coding that are commonplace, but not always understood, are upcoding and downcoding. Both involve […]

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Creating a Better Reconciliation Process for Anesthesiology Billing

When it comes to successful anesthesiology billing, it’s important to collect every bit of revenue possible. Even one missed or overlooked case can result in losing hundreds – if not thousands – of dollars of revenue. And given the high caseload many anesthesiologists face, overlooking a case now and then happens more than you’d think. […]

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Navigating Three Key Compliance Issues for Anesthesiologists

Running an anesthesia practice means complying with a labyrinth of rules and regulations. There are three related compliance issues that many anesthesiologists have a difficult time abiding by, and all of them have to do with payment. These compliance issues are: Professional courtesy fee waivers Co-payment waivers Discounts for cash payments Many practices encounter these […]

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