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 […]
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 […]
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 […]
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 […]
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 […]
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. […]
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 […]
Beginning in 2017, MIPS (Merit-based Incentive Payment System) will make up an important part of a provider’s payment from CMS. A higher MIPS score can lead to more revenue for a practice – and a lower MIPS score can lead to penalties that will decrease revenue from CMS. Each year, CMS will set a threshold […]
The idea of a “surprise bill” – a bill that contains costs the patient didn’t expect or necessarily know about before treatment – has been around for decades. Now, though, legislatures and regulators at the state and federal level have begun to take action against surprise billing to protect consumers. Here’s how it usually works: […]
Compliance, for an anesthesia practice, is quite different from other medical practices and specialties – and can even differ within the anesthesia field. Because so much depends on proper compliance, practices need to understand what is required of them when it comes to complying with rigorous documentation requirements. However, many providers – even those with […]
