CMS has replaced the general and lab advanced beneficiary notice with the Advance Beneficiary Notice (ABN) of Non-coverage. The new titled notice requires physicians and other healthcare providers to use a new form when services are not expected to be covered by Medicare.
Drug Safety Alerts: Moving Past the Pony Express to the 21st Century safety alerts.
Have you ever wondered why you are able to get up-to-the-minute sports scores, but it could take weeks to receive potentially lifesaving drug safety alerts? (And that is only if your front-office staff is able to separate the “Dear Doctor” letter from junk mail.)
Boost Revenue with Denials Management, Appeals
Denials management and appeals are the two most underestimated processes in rheumatology offices. Most practices lose thousands of dollars every year because they are not following up or writing off denied claims correctly.
To Document or to Doctor? That Is the Question
Is paper pushing taking away from patient care?
Avoid Compliance Risks When Using Billing Companies
Outsourcing your billing to a third party will not alleviate your compliance duties or reduce your risk of a government investigation. Conversely, a relationship with a third-party biller can increase your compliance obligations and raise audit risks.
A New Twist in the Consumerization of Healthcare
Who are the new medical consumers? These people behave like medical “shoppers” because they are more mobile than previous generations and are empowered by the Internet. They can research and form opinions about diseases, treatment options, and the best route to recovery—all before stepping foot in to an exam room. This emerging population has been taught that in order to be a health-wise consumer and to get the most value, a patient must take an active role in his or her care.
How Medically Unlikely Edits Affect a Practice
Medically unlikely edits (MUEs), formally known as medically unbelievable edits, took effect with the Centers for Medicare & Medicaid Services (CMS) on January 2, 2007. The function of MUEs is to detect and deny unlikely CMS claims on a pre-payment basis with the intention of improving Medicare’s payment process.
Mind Your Accounts Receivable
Over time, one would expect financial management of a medical practice to become more streamlined and simple. With the abundance of electronic tools, software programs, and the Internet, you can find assistance and problem-solving strategies for economic efficiency. In the rush to take advantage of these support tools, basic facets of financial management, such as billing and collection, have fallen by the wayside.
Missed Appointments Equal Missed Revenue
What do you do when a patient misses an appointment? While an opening in the schedule might seem like a good time for staff to take a break or catch up on their to-do lists, missed appointments are a growing problem in physician practices. With today’s need to maximize every dollar, practices should take a closer look at the effect these missed appointments have on their bottom lines.
Clean Claims Equal Prompt Payment
Submitting a clean Medicare reimbursement claim the first time can save your practice thousands of dollars each year. The Centers for Medicare and Medicaid Services (CMS) defines a clean claim as “a submitted patient claim form without any defect or need for substantiation.”
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