Billing & RCM

Resolving insurance claim denials can be a time-consuming process that often gets placed at the bottom of the to-do list. Below are two common claim denials, how to resolve them, and how to avoid them in the future. 2 Common Insurance Claim Denials Patient not...

Team Approach. Many physician practices have one or two medical billers. Think about the progress that can be made reducing your outstanding claims with a team of people working on them. Outsourcing your billing comes with a team approach. Multiple people are...

As medical insurance deductibles continue to increase, medical practices must put processes in place to ensure they maximize patient collections. Here are four simple steps you can take today to optimize your patient collections. How Does a Medical Practice...

Medical practices cannot conduct business in today’s market like they have in the past. Medical costs are soaring, and reimbursement is not increasing at a rate to offset expenses. It is vital that we have a pulse on our revenue cycle to ensure timely and accurate...

When is the last time your practice reviewed its fee schedule? We find most practices set a fee schedule and seldom perform annual reviews. Fee schedules get outdated just like coding. Every year, payers update their fee schedules for current and new CPT codes, so it...

Medicare’s Target Probe and Education (TPE) is a new initiative of the Medicare Administrative Contractors (MACs) to review clinical documentation and prevent improper payments. The goal of the program is to help practices quickly improve by limiting the number of...

Become and Stay in Compliance Each year the Office of Inspector General (OIG) develops a work plan to combat fraud, waste and abuse in the healthcare space. Some areas they will focus on this year include: Medicare Part B Payments for Psychotherapy Services Review of...

The Centers for Medicaid and Medicare Services (CMS) started a fraud prevention initiative for 2018. By removing social security numbers from a beneficiary’s Medicare ID card and assigning a random number, the organization hopes to dramatically reduce the amount of...