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 […]
For anesthesia practices participating in the Physician Quality Reporting System (PQRS) from CMS, there are four ways to take part: claims, qualified registries, electronic health records (EHR), and a fourth option known as qualified clinical data registries (QCDRs). Most providers utilize one of the first three methods to submit data to CMS. However, there is […]
There’s one thing that every medical practice has in common: in order to make it, you have to get paid. If getting paid were easy, though, practices wouldn’t have revenue problems. The truth is, these problems do exist because getting paid is a challenge – to the point that a recent survey of practice owners […]
Earlier this year, the Center for Medicare and Medicaid Service (CMS) announced its latest payment program: the Comprehensive Primary Care Plus (CPC+) model. Set to start at the beginning of 2017, CPC+ is a payment model that will give a monthly payment to providers to manage care for patients, in an effort to create more […]
In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act, known as MACRA. Since then, regulators have been working on releasing guidelines and programs governing MACRA, and many of these impact anesthesiologists. Parts of the proposed rule (it hasn’t gone into effect yet) were announced on April 27 and discussed on this blog previously, […]
