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 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 there is one thing every anesthesia billing program needs, it’s a reconciliation process. A reconciliation process for billing ensures that two different sets of records match up, or are in agreement. In other words, it matches billings to revenue – making sure you are getting paid for what you have charged. Without a reconciliation […]
“Surprise billing” is a phenomenon in which patients receive bills that are either higher than anticipated, or contain charges that they did not expect and were not informed of prior to treatment. Typically, this happens because a patient receives treatment, then finds out that one or more providers involved in treatment fell outside of the […]
The Centers for Medicare and Medicaid Services (CMS) operate something called the Physician Quality Reporting System, a quality reporting program that allows providers to submit information on quality of care to Medicare. As a part of the program, CMS can institute a negative payment adjustment to any provider who doesn’t “satisfactorily report data on quality […]
