Few things are more frustrating to a practice than having a claim denied by a payer. Denied claims result in delayed payments at best, and no payment at all at worst. Many practices don't know why certain claims are denied, or why their claim denial rate is as high as it is. Fortunately, practices can […]
Value-based reimbursement has become the standard for medical billing and coding. Years ago, when value-based reimbursement was just coming into its own, many providers doubted that it would take hold. Now, though, it has been wholeheartedly endorsed by CMS – through its Merit-Based Incentive Payment System – and many private insurers. It is estimated that […]
Medical practices of all kinds are always concerned about patient collections, especially as out-of-pocket expenses for patients increase. With an increase in these expenses comes more difficulty with collecting all of the payments a practice is owed for its services. Hence, approving patient collections is of paramount importance for a medical practice. Here is more […]
Excessive days in accounts receivable (A/R) can hinder the financial health of an anesthesia provider, and constitute one of the main problems anesthesia billing and coding specialists have with a practice. There are many reasons why days in A/R rise, and often, they increase without anyone really knowing why – or even being aware that […]
For virtually all practices out there, it's no secret that the federal government is offering $36 billion worth of incentives for practices that incorporate electronic health records (EHR) into their system. Of course, EHR adoption offers more benefits for a practice than just free government money (although that benefit is usually what gets everyone’s attention). […]
Every year, the Office of the Inspector General for the Department of Health and Human Services releases a Work Plan that covers the office's plan to oversee, audit, and ensure compliance with all programs and guidelines under the DHS aegis. The Work Plan is a starting point for any provider that is paid under the […]
The Physician Quality Reporting System (PQRS) is a quality reporting system created by the Centers for Medicare & Medicaid Services designed to properly assess the quality of care that is provided to patients. Providers can use PQRS to quantify how often they are meeting a certain quality metric, and can modify their care based on […]
The Centers for Medicare & Medicaid Services (CMS) enacted the Patient Access and Medicare Protection Act on December 28, 2015, which considered hardship exceptions for certain eligible healthcare professionals when it comes to the EHR incentive program. As a result, certain eligible professionals (EP) are exempt from filling out a hardship form to exempt themselves […]
The fee-for-service payment model has dominated medical practices for as long as anyone can remember. But a relatively new trend – value-based payment – may be on the verge of replacing fee-for-service across the nation. The fee-for-service model emphasizes payment based on the volume of services provided to the patient, regardless of outcomes and patient […]
If you are an anesthesia provider in the state of Alabama, there are certain guidelines you need to be aware of in order to abide by all policies and regulations and ensure you are properly billing and collecting your claims. Here are a few anesthesia billing guidelines your practice should follow. Claim Filing Effective for […]
