Why Quality Documentation Matters

Posted by Nancy Clements on Nov 10, 2021 3:45:00 PM
If you work with provider claims in a medical office, then you have probably heard the phrase, “If it isn’t documented, it wasn’t done.” But a 2020 Center for Medicare and Medicaid Services (CMS) report found that more than 70 percent of claims submitted for payment were paid improperly, meaning something was incomplete or missing from the documentation submitted with a claim.
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Topics: carrier contract guidelines, medical billing, Medicare fraud, medicare compliance, patient billing

How to Negotiate Payer Contracts: Expert Insights for Your Practice

Posted by Practice Management Institute on May 10, 2021 6:22:38 PM

Contract review is a delicate dance but doing your homework and negotiating for a better deal helps to achieve a better outcome, says healthcare attorney, Heidi Kocher, JD, MBA, CHC, of DC-based Law Firm, Liles Parker. Before you start the negotiation process, here are a few things to consider.

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Topics: Practice management, contract negotiation, payer contract, carrier contract, value proposition, carrier contract guidelines, Heidi Kocher, medical practice benchmarking

Practice Managers and Auditors: Learn to Stand Your Ground with Payers

Posted by Nancy Clements on Apr 13, 2021 5:15:06 PM

Changes to healthcare delivery, and billing codes during the pandemic, along with major updates to the E/M documentation guidelines have created a ripe environment for government-contracted auditors. But you have the right to challenge auditors. Take steps now to establish your culture of compliance.

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Topics: Practice cash flow, payer contract, carrier contract guidelines, medical office, medical billing, financial management, auditing

Education and Hard Work Have Helped Elizabeth Daley Set a Strong Foundation for Career Growth

Posted by Nancy Clements on Mar 10, 2021 12:39:18 PM

Elizabeth Daley, MHA, CMIS, CMOM, CMCO, is Director of Client Success at Collect Rx, a 15-year-old company launched by former executives from third-party vendors who pioneered the out-of-network (OON) industry. The company works with 2,100 clients across the country and have built a proprietary database with thousands of claim resolutions at their fingertips to facilitate and expedite the negotiation process.

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Topics: Practice cash flow, value proposition, carrier contract guidelines, medical practice issues, medical billing, financial management