Streamline Prior authorizations can be a real pain, but with a few adjustments, you can make the process smoother and save yourself and your patients some stress. Here are 5 tips to streamline prior authorizations: Know Your Triggers: Become familiar with medications and procedures that frequently require prior authorization. Identify alternative options, like generics, that […]
Embrace the Denial Management Makeover and discover how to improve cash flow, streamline billing, and finally conquer denied claims. There are few things worse than denies for any healthcare provider. They disrupt patient care, but they also add to their financial burden. Denied claims mean lost revenue, impacting your cash flow and making it hard […]
New billing codes: Medical experts might consider creating new billing codes for the time doctors and their support staff spends working on prior authorizations. The American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Board meets May 9-11 in Chicago. On the meeting’s agenda are three potential new CPT codes “for reporting services (physician, QHP, […]
A Guide to Accounts Receivable (A/R) The healthcare practice’s Accounts Receivable (A/R) encompasses various complexities and subtleties. The Accounts Receivable process is continually evolving, presenting numerous challenges. Although A/R challenges may not solely determine success, improving A/R turnaround time can have a significant impact. Based on an MGMA Stat poll, 56% of medical groups reported […]
KEY TAKEAWAYS Denials rose to 11% of all claims last year, up nearly 8% from 2021. Revenue cycle leaders should place their focus on clinical validation denials to help ease the overall denials burden. A key defensive strategy for preventing denials is provider education. Revenue cycle leaders need to understand that clinical validation denials are […]
The difference between a financially and clinically successful practice and one that is struggling often comes down to whether they have the code right and document thoroughly. Changes in 2021 to major coding categories, such as evaluation and management (E/M) coding for office visits means major change that can hamper your operations if not done […]
It’s autumn, and along with leaves changing color, pumpkin spice lattes, and cooler weather comes an avalanche of TV ads, commercials, and telephone marketing calls, all entreating us to believe that Medicare Advantage (MA) is the best thing since the invention of the cell phone. With open enrolment season upon us, it’s critical to examine […]
Usability and interoperability are top physician complaints, but will 2021 bring any relief? Physicians often see the EHR as the bane of their professional existence, complaining about awful user interfaces and a lack of interoperability with other systems that forces them to access multiple platforms to get the information they need on one patient. But […]
86% of medical group practices in an MGMA report said regulatory burden rose in the last year, with prior authorizations and the Quality Payment Program adding to that burden. A vast majority of medical group practices experienced growing regulatory burden in the last year, with prior authorizations and Medicare’s Quality Payment Program topping their list […]