Author

Elizabeth

  • [addtoany]
    The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) created new ways for the Medicare program at CMS to pay physicians for the care they provide to Medicare beneficiaries. MACRA also creates incentives for physicians to participate in Alternative Payment Models (APMs), including the   Read more..
    Posted on 18 Sep, 2017
    By Elizabeth
    MACRA & the Role of Physician-Focused Payment Model Technical Advisory Committee (PTAC)
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    Payers get the upper hand because they are huge companies that can funnel resources into figuring out how not to reimburse you. Their most recent shell game is prior authorization. “When I started out [prior authorization] never came up,” says Kevin de Regnier, an osteopath who   Read more..
    Posted on 15 Sep, 2017
    By Elizabeth
    3 Ways to Outsmart Prior Authorization Ploys
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    The demand for physicians available for hospital call coverage is rising, but such arrangements must be structured carefully to avoid running afoul of the Stark Law and AKS. Since every arrangement is different and unique to the circumstances of specialty, geography, demand, and other various concerns,   Read more..
    Posted on 11 Sep, 2017
    By Elizabeth
    Compliant On-Call Coverage Arrangements
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    Documentation helps to inform and support providers by supplying information to highlight trends, providing insight into disease processes, and uniting physician teams and payers through the flow of data. Clinical records provide uniformity and continuity across visits, hospitals, physicians, and payer providers. Bottom Line: Documentation is the   Read more..
    Posted on 8 Sep, 2017
    By Elizabeth
    Clinical Documentation: Why is it so Important?
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    Is your ASC’s business office set up for optimal profitability and compliance? Chances are that it’s not, says Cristina Bentin, CPPM, CPCO, CCS-P, CMA, President of Coding Compliance Management in Baton Rouge, LA. As a consultant, Bentin helps ASC managers spot and correct problems. She highlighted   Read more..
    Posted on 1 Sep, 2017
    By Elizabeth
    Spot and Stop These 7 ASC Business Office Pitfalls
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    Lack of firewall in secondary systems shows why risk analysis is crucial in healthcare settings.
    Large organizations look at the big picture, forgetting oftentimes that it’s a small chink-in-the-armor that renders a downfall. Such is the case involving the University of Massachusetts at Amherst (UMass), who despite the best intentions, fell victim to a HIPAA disaster after a malware issue   Read more..
    Posted on 24 Aug, 2017
    By Elizabeth
    Malware Issue Highlights Need for HIPAA Security Plan
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    Make no mistake—there is a lot of uncertainty swirling around healthcare. But one thing you can count on is a transition from “fee-for-service” reimbursement to value-based reimbursement. Federal and private payers are no longer content to reimburse providers simply for the number of procedures they perform.   Read more..
    Posted on 22 Aug, 2017
    By Elizabeth
    Welcome to the Patient-Centered Care Revolution
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    The best traditional marketing for your healthcare practice is virtually free. Referrals, nonetheless, are invaluable. Referrals help to attract new patients, boost your bottom line, increase brand awareness, and allow your practice to grow and thrive. So when you create a network of happy patients by   Read more..
    Posted on 22 Aug, 2017
    By Elizabeth
    Create an In-Person Referral Network to Boost Your Business
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    When faced with an angry patient, remember the 5/20 rule.
    Patients who visit healthcare organizations often bring along family members or friends and are usually experiencing a degree of emotional and physical stress. This stress can sometimes affect their reactions to a situation. When service failures and complaints occur, you need to have tools in   Read more..
    Posted on 17 Aug, 2017
    By Elizabeth
    Angry Patients, Service Foibles, and the 5/20 Rule
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    KNOW THE BASICS
    You append modifier 22 (Increased procedural services) to a CPT® code to indicate that a surgical procedure requires physician work substantially greater than that usually required to perform the service. There is unfortunately no one standard definition of what “substantially greater” effort means. You should   Read more..
    Posted on 15 Aug, 2017
    By Elizabeth
    Don’t Labor Over Modifier 22 – Increased Procedural Services