Pain management treatments are primarily performed by an interventional pain management specialist, physiatrist, anesthesiologist, orthopedic surgeon, or neurosurgeon, and can include physical or occupational therapy, over-the-counter or prescription medication, neurostimulators, and injections.

Topics: medical billing, Pain Management, medical coding, patient billing, medical office training

Putting on the dreaded collections hat is a necessary evil that every medical office can relate to. You can run a tight ship, doing your very best to collect payments at the time of service, but because of the complexities of medical billing and emergent situations, there will always be times when collecting every patient's payment is an impossibility. Documenting best strategies for more expeditious patient payment practices will help the team get it done.

Topics: medical billing

Consumer healthcare spending continues to rise, not surprisingly due in part to the COVID-19 pandemic. National health spending projections for 2021-23 will continue to inch upward 5.4 percent per year, according to research compiled by the National Health Expenditures Accounts (NHE). Insurers have tightened the reins shifting more financial burden to their members. And with inflation, furloughs, unpaid family leave, and mounting medical and prescription costs, it's no surprise that family budgets are stretched thin.

Topics: Practice debt, medical practice issues, medical billing, patient billing, patient collections

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.

Topics: carrier contract guidelines, medical billing, Medicare fraud, medicare compliance, patient billing

The rapid evolution of telehealth services has helped keep medical practice virtual doors open to meet their patients' health needs during the pandemic. But with new utilization comes cautionary areas from a billing standpoint, and it's important to stay current on updates and compliance protocols to promote revenue growth and avoid financial loss. 

Topics: Practice management, payer contract, medical office compliance, medical practice issues, medical billing, financial management, medical coding

Pay careful attention to the latest reimbursement, compliance guidelines, and waivers as you integrate telehealth into patient care, experts warn. As the newness wears off, denials could start rolling in if you aren't watching the updates closely. 

Topics: Practice management, Practice cash flow, medical office compliance, medical practice issues, medical billing

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.

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

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.

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

A Medical Office Manager’s Guide to Patient Collections

Topics: Practice cash flow, medical office manager topics, medical billing, financial management

In a busy medical practice, the risk of error runs high. This is a dangerous assertion when you consider that mistakes in a medical record can negatively impact a patient’s health. Mistakes made repeatedly in medical claims may flag your practice for an audit and, if overpayments are found, can result in huge fines and penalties from the government.

Topics: Practice management, PMI Certification, cmom certification, medical practice issues, medical fraud, medical billing, medicare

Portions of this article were originally published in BC Advantage Magazine March 5, 2019

A whopping 25 to 31 percent of total health care expenditures in the U.S. are administrative costs, according to a time-driven, activity-based costing study published last year in the Journal of the American Medical Association (JAMA)¹. These are huge margins for healthcare providers already squeezed by insurers and increasing costs of care. You may wonder if the grass is greener on the other side.

Topics: Practice management, CMOM, PMI Certification, Certified Medical Office Manager, medical office manager topics, medical practice issues, medical billing