Medical Billing & Credentialing News

  Measuring Healthcare Outcomes Healthcare Practice Key Performance Indicators Matter So, your  healthcare practice  is running smoothly. You’ve hired fantastic people, followed a marketing plan, placed the right technology and your patient retention policy is in full swing with a low churn rate. Things are going great, right? Well, there’s no way of really knowing for sure unless you’re measuring your performance. Only by carefully tracking metrics (Key Performance Indicators or KPIs) in your medical practice can you actually improve efficiency, profitability and yield better results across your entire practice and revenue cycle management operations .  Choosing what to measure and what to report, however, is as important as deciding to start tracking measurements in the first place.  In this post, we will cover some of the key metrics that will measure the pulse of your medical practice. To begin, exactly how would you  describe these Key Performance Indi...

  The Reasons Why a Medical Billing Assessment is Needed Medical Billing Assessments Running a healthcare practice means keeping a tight ship for the sake of your patients and your reputation, as well as your financial well-being. But, let’s face it, practices are only as successful as their  medical billing  performance. If you have a prosperous practice but still want to evaluate or tweak specific features of your billing practices, a medical billing assessment will be a big help. So just what amounts to a medical billing assessment? A typical assessment will include a comprehensive review that focuses on: Examining  your practice’s billing performance Assessing  its guidelines and processes Gauging  the technology and tools the practice employs Reviewing  patient care workflow Assessments are key in offering a tool to gauging things we are doing well and things we could be doing better. Okay, but why should you perform a medical billing assessment? ...

Outsourced COVID-19 Testing Billing Advantages COVID-19 Testing Scenario Jude Hunt, 81 years old, said she waited in line for her second PCR test a few weeks ago after her vaccinated housekeeper tested positive for COVID-19. She said she previously contracted COVID herself and received the vaccine, but added, “ After the last two years, I’m not taking any chances .” David Gallego, a medical technician at a mobile testing site, said  he has witnessed the number of people stopping by for COVID tests double the past few weeks,  to about 100 people a day. More Americans are being tested for COVID – and waiting longer for results – as virus cases surge and places from offices to concert venues require people to show proof they aren’t infected.  Laboratories in the U.S. processed an average of 713,000 daily tests for the virus’s genetic material as of August 2, 2021 , according to the Department of Health and Human Services. That’s an increase from about half a million in early...

  The Gravity of Ethical Medical Billing Practices The Hypothetical Case of Dr. Michael Stevens’ Unethical Medical Billing Behavior The case of  Dr. Michael Stevens  is an illustration of the worst-case scenario when unethical behavior impacts  medical billing . An anesthesiologist and owner of a pain management clinic,  Dr. Stevens was obliged to relinquish his medical license when it was uncovered that his in-house medical biller was committing fraud.  The biller,  Edward Bailey , a family member with no experience or proficiency in medical billing, had met with a Medicare contract provider to ask for counseling on which CPT codes to use for a new treatment the practice had begun to make available.  Soon, claims that had formerly been denied by payors began to come back approved. However, when the state licensure board initiated an investigation of Dr. Stevens, they detected that the practice routinely billed the same five  CPT codes  ...

  7 Strategies to Maximize Patient Collections Any medical provider knows how difficult it is to get paid for their services.  73 percent of healthcare providers assert that it takes 30+ days to recover their payment fully.  Various issues like complicated billing procedures, changing payer fee schedules, employee attrition, government directives, lack of training and resources and high-deductible health plans complicate the payment cycle. Plus, the important communication triangle among the healthcare provider, the patient and the insurance company only aggravate the problem. To get paid efficiently, medical providers need to establish better systems and procedures that provide lasting success . This post provides a concrete guideline for medical billing collection. Here are 7 Medical Billing Strategies to Boost Patient Collections: Educate your Patients on Claims Processing Process Insurance is complex and is getting more so. That’s certainly not news to those in the pr...