When it comes to medical billing errors, the numbers are staggering: as many as 80% of all medical claims submitted to insurance carriers contain errors costing approximately $68 billion. Additionally, the incorrect coding of about 55% of evaluation and management (E/M) claims has resulted in roughly $6.7 billion worth of erroneous Medicare payments. Physicians […]
Modifier codes are sometimes used to signal abnormal circumstances related to anesthesia care. These 5-digit qualifying circumstances codes are recognized as modifiers when they are billed as separate line items in order to report services that were provided under unusually difficult circumstances (i.e. unique operative conditions, extenuating issues with the patient’s condition, etc.). Read on […]
Healthcare acronyms are everywhere – MACRA, EMR, PHI, HIPAA. They can be confusing, and it’s easy to get them mixed up – but using the wrong acronym could lead to HIPAA mistakes. Your providers and staff may use health-related acronyms regularly, but that doesn’t necessarily mean they are all on the same page – or […]
Medical billing reports can tell you a lot about the health of your practice. For example, they can show you how your practice is doing on revenue cycle metrics, whether claims are being paid on time, and how well (or how poorly) insurance carriers are paying you. But which reports are the best ones to […]
We all know that 2017 is slated to be a year of great change, both politically and medically. With MACRA’s implementation this year, there’s a significant learning curve for everyone in the medical field – which means there’s no better time to make a change that will simplify your practice’s daily operations. Not only does […]
As the value-based care trend continues, Certified Registered Nurse Anesthetists (CRNAs) will face a variety of challenges. But what do these challenges look like, and how will value-based care affect the future for CRNAs? Read on to learn more. Proper Valuation Currently, the trend is to move away from fee based service and toward bundled […]
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 […]
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: […]
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 […]
