Category: Blog

  • November 30, 2017

Improving ASC Upfront Collections: 5 Fundamental Steps In Obtaining Payer Pre-Authorization

Your ASC’s surgery scheduler has just scheduled a procedure for next week. Prior to performing this procedure, there are numerous steps required to ensure that your ASC is properly compensated for services performed. Pre-authorization — also called pre certification, prior authorization, insurance verification and prior approval — from the patient’s payer is just one vital […]
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  • November 28, 2017

How Much Do Claim Denials Cost Hospitals? New Report Says $3.5M

Hospital and health systems have seen an improvement in some aspects of revenue cycle performance over the last two years, but a new report finds that many organizations are under pressure and face risks from increased denial write-offs, bad debt and inefficiencies due to high collection costs. Indeed, the Advisory Board’s biennial revenue cycle survey […]
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  • November 14, 2017

When Appeals Are Not Enough

If you are as enthusiastic about medical billing and reimbursement, it can be vexing when we receive a denial. Here are some tried and true points that every biller should know to address a true appeal correctly. Know Your Coding: In today’s multi-tasking office you will often find billers who are certified in both collections […]
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  • November 14, 2017

CMS Finalizes 2018 MPFS Payment and Policy Changes

The Centers for Medicare & Medicaid Services (CMS) has finalized 2018 payments and policies under the Medicare Physician Fee Schedule (MPFS). Most notable is the leniency in adopting federally-mandated policies. MPFS Final Rule Highlights: Taking into account the 0.5 percent automatic adjustment under the Medicare Access and CHIP Reauthorization Act (MACRA), CMS estimates the resource-based […]
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  • November 7, 2017

How Physicians Can Stabilize Revenue? Stabilize Your Revenue With These Tips

Physician practices are facing confusion and frustration due to the shift to value-based care and the ever-rising cost of care. Physicians seeking to stabilize their revenue amidst this chaos typically find themselves facing several challenges. 1. Collecting Patient Payments: Enrollment in high-deductible health plans is growing rapidly, leaving patients responsible for a larger portion of […]
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  • November 7, 2017

CMS Releases Physician Fee Schedule For 2018: 6 Things To Know

CMS issued its 2018 Medicare Physician Fee Schedule, which cuts Medicare payments for services provided by certain provider-owned off-campus hospital departments. Here are six things to know about 1,250-page final rule: 1. Physician payment rates will increase 0.41 percent in 2018 compared to this year: CMS arrived at this increase after accounting for a 0.5 […]
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  • October 31, 2017

How Small Practices Can Increase Revenue

Virtual Groups Will Allow More Clinicians To Participate In Mips To Earn Incentive Payments: Clinicians who were ineligible to participate in the Merit-based Incentive Payment System (MIPS) in 2017 will have a better chance of qualifying in 2018. Although the Centers for Medicare & Medicaid Services (CMS) has proposed to increase the low-volume threshold, they’ve […]
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  • October 25, 2017

Ending the Aging Process: How to Control Your Accounts Receivable

When your reimbursement staff is working old accounts receivable while also trying to stay up-to-date with current billing and collection activity, they can quickly feel overwhelmed. While the high dollar claims always need to remain a priority, you also need to keep a watchful eye on aging claims to ensure that NOTHING is resolved past […]
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