The Merit-based Incentive Payment System (MIPS) is one pathway of upcoming MACRA’s Quality Payment Program. One of MIPS’ four components is the “quality” category, which ultimately comprises 50% of a provider’s MIPS score. But what is the MIPS quality category, and how does it work? Below, we’ll take a closer look at the MIPS quality […]
The Merit-based Incentive Payment System (MIPS) is one of two pathways in MACRA’s Quality Payment Program. Most anesthesia providers will be eligible for MIPS participation and will have their MIPS score calculated, as MIPS applies to all Medicare Part B physicians, physician assistants, nurse practitioners, and certified registered nurse anesthetists. Here, we’ll talk more about […]
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 After a lot of patching and ho-humming about the situation, Congress finally repealed the SGR formula […]
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 […]
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 […]
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 […]
