Revenue cycle management is the foundation for a successful medical practice. Without a profitable and organized management structure, a practice can lose thousands – if not tens of thousands – of dollars a year in lost earnings. Having healthy revenue cycle management means knowing how to avoid and mitigate a lot of common problems with […]
The number seven pops up a lot throughout history. The Bible says it took God seven days to create the Earth (and rest). If you break a mirror, you get seven years’ bad luck. Seven is a lucky number that inevitably shows up on millions of lotto tickets each week. But for ICD-10 coding, the […]
Provider credentialing is a complex, yet critical, process for virtually any healthcare provider. Without credentialing, reimbursement for providers can be delayed or denied – meaning that a practice’s revenue cycle depends on accurate and correct provider credentialing. Credentialing involves a verification of a provider’s experience, expertise, and ability to provide meaningful medical care for his […]
Anesthesia billing differs from most other physician billing, in which there is generally a fee-for-service-based payment. Instead of being on a fee-for-service schedule, anesthesia providers are paid according to a different system consisting of base units, time units, and modifiers. The more-complex nature of anesthesia billing means there is more potential for error, which can […]
Earlier this year, the Office of the Inspector General of the Department of Health and Human Services vowed to crack down on health care fraud. In the words of the Inspector General: “Health care fraud drives up healthcare costs, wastes taxpayer money, undermines the Medicare and Medicaid programs, and endangers program beneficiaries.” As a result […]
Blue Cross Blue Shield of Alabama has released updated changes for Monitored Anesthesia Care (MAC) reimbursements released to GI cases. The new effective date is December 28th 2015. As BCBS has released limited information we anticipate many changes before the implementation date. What we know as of today, BCBS will reduce reimbursement to the GI […]
When it comes to anesthesiology billing, timing is everything – literally. More emphasis is placed on the timing around a procedure in anesthesiology billing than perhaps any other specialty, due to the inherent nature of the practice. To bill correctly – and avoid costly audits, as we previously discussed – it’s essential to properly record […]
Anesthesiology providers are some of the more vulnerable providers when it comes to Medicare audits, due to the complex nature of not only delivering care, but billing and coding for any procedure, as well as calculating timing. Because of this vulnerability, the federal government has been particularly aggressive toward anesthesiology providers, especially since the Recovery […]
ICD-10 implementation has come and gone with the October 1st deadline, and so far, providers are caught up with staying ahead of the formidable task of ensuring payments and accurate claims in the face of an unprecedented change. ICD-10 brought with it 68,000 diagnosis codes and 76,000 procedure codes that are required for billing and […]
Earlier this year, the Office of the Inspector General of the Department of Health and Human Services vowed to crack down on health care fraud. In the words of the Inspector General: “Health care fraud drives up healthcare costs, wastes taxpayer money, undermines the Medicare and Medicaid programs, and endangers program beneficiaries.” As a result […]
