Denials: The Growing Concern

[vc_row][vc_column][rev_slider_vc alias="denials-growing-concern"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Denials are a fact of life for every medical practice. From demographic errors to medical necessity, denials come in easy to fix solutions and time-consuming levels of appeal. A recent article from the Healthcare Finance News website (http://www.healthcarefinancenews.com/news/denials-still-major-risk-revenue-cycle-departments-despite-build-out) noted that hospitals in particular “wrote off as uncollectable 90% more denials than 6 years ago.” The news is not all negative though. The article notes that “Medicare and Medicare advantage...

Donna White
Share

MIPS: Are you ready?

[vc_row][vc_column][rev_slider_vc alias="mips123"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Previous government incentive programs like Physician Quality Reporting System (PQRS) and Meaningful Use (MU) have officially been phased out as of 2017. In healthcare, we have a new alphabet soup to work with to receive Medicare incentive payments called the Merit-based Incentive Payment System, or MIPS. In this article we’ll try to de-mystify some of the more complex aspects of the system. This system combines the previous measurement programs under...

Donna White
Share

Practice Analytics

[vc_row][vc_column][rev_slider_vc alias="practice-analytics"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]You have heard the term from every technical vendor your work with – they will provide you a dashboard that will review for you top issues in your systems, compare your practice to similar sized practices and show where you rank nationally among their customers. While this is helpful data, reporting and analytics can be used to determine so much more. Clinical Reporting You are entering in so much information every...

Donna White
Share

Working Common Denials (part 2)

[vc_row][vc_column][rev_slider_vc alias="working-common-denials-part-2"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text] In today’s article, we are going to continue to review best practices for follow up on some of the most common denials, regardless of specialty. Missing Information There are several types of common Missing Information denials. First you may be missing Medical Records. In this case, the payor needs the chart or progress note to process the claim. Call the payor and see if the records can be faxed. Be...

Donna White
Share

Credentialing and CAQH Completion

[vc_row][vc_column][rev_slider_vc alias="credentialing-and-caqh-completion"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]One of the most important pieces to opening a new practice, or moving from one practice to another, is your payor Credentialing. This is a time intensive process most providers or office managers do not have the bandwidth for. This is where outsourcing your credentialing can be critical. You typically want to allow a minimum of 90 days prior to your practice opening, or move, to begin your credentialing...

Donna White
Share

Working Common Denials (part 1)

[vc_row][vc_column][rev_slider_vc alias="common-denials"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Depending on your practice, there may be several types of top denials. In today’s article, we are going to review best practices for follow up on some of the most common denials, regardless of specialty. Coverage Termed/Expired Per the EOB, the patient’s service denied as Coverage Termed or Expired at the time of the service. In your practice management system, check the Insurance Screen’s eligibility area to see what eligibility information...

Donna White
Share

Three Ways to Leverage Expectations for Growth

[vc_row][vc_column][rev_slider_vc alias="clear-expectations"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]If you’re a leader, you probably have a drive in you to do things with excellence. You also probably have a specific perspective of what “right” looks like, and high expectation for things to be done in that right way. For leaders, this is a great and valuable thing. Knowing what you expect of your team, and your team knowing what is expected of them is essential to growth...

Donna White
Share

From Patient to Consumer: How to Improve Patient Collections

[vc_row][vc_column][rev_slider_vc alias="continuous-improvement"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Today patients have some of the highest deductibles and out of pocket expenses in history. Patients also typically take twice as long as insurance companies to pay on their bills, and even then, it is usually only a portion of the balance. Practices and Hospitals that can make a shift of thinking about their patients as customers, as well as patients, have a greater chance in collecting patient balances....

Donna White
Share

Front End of Revenue Cycle Management

[vc_row][vc_column][rev_slider_vc alias="rev-cycle-management"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]When analyzing the full Revenue Cycle, a lot of emphasis is spent on the back-office pieces of billing. However, there are some front office policies that, if put in place, will save rejections and denials on the back end. It All Starts with Scheduling Your scheduling department should be well versed on your practice. This starts with how long each visit type typically lasts (new patient vs. established patient vs....

Donna White
Share

Benefits of Being Mentored

[vc_row][vc_column][rev_slider_vc alias="mentoring"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Every great leader has been led greatly. To truly become the leaders we are capable of being, we need others who can pour into our lives and bring greatness out of us. Everyone needs a mentor. Here's three reasons why: They can see your blind spots. Great mentors can help you see things in you that you cannot see in yourself. This is great for two reasons. As a leader, you have...

Donna White
Share