“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 […]
Negotiation may play more of an active role in bundled payments, one of the fastest-growing models of anesthesiology billing in the industry today. Here’s more on the role of negotiation in bundled payments in anesthesiology billing. Bundled Payments and the ACA Payment for services rendered by anesthesia providers fall into one of six categories: Fee-for-service […]
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 […]
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 […]
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 […]
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 […]
The rising cost of healthcare across the board has made patient collections even more crucial than they already were. Practices and providers across the country have had to deal with difficulties ensuring all their payments are collected in full and on time. This has resulted in cash flow problems for many, problems that largely can […]
For your practice to remain successful, all charts must be coded and billed on time. Incomplete and denied claims put a delay on collecting your accounts receivable. With unexpected mishaps, you cannot always find extra time and experience internally. The most effective way to improve accounts receivables efficiency is to eliminate denials through outsourced medical […]
