Navigating Carrier Guidelines for Optimal Practice Reimbursement

Posted by Nancy Clements on Jul 6, 2023 4:25:20 PM

When a Medicare patient has multiple sources of insurance coverage, Medicare will only pay for services after the primary payer has processed the claim and made their payment.  Medical office staff must always verify the patient's insurance coverage thoroughly - gathering all necessary information from the primary insurance, such as policy numbers, claim submission instructions, and any preauthorization requirements, etc.

Read More

Topics: Practice cash flow, payer contract, carrier contract, carrier contract guidelines, medicare compliance, patient billing, claims, insurance

Pain Management Coding: guidelines for correct claim submission

Posted by Practice Management Institute on Sep 19, 2022 9:45:00 AM

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.

Read More

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

Successful Patient Collections: Test Your Knowledge

Posted by Nancy Clements on Jan 28, 2022 8:00:00 AM

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.

Read More

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

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.
Read More

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

Tips for Better Revenue Cycle Management in a Medical Office

Posted by Practice Management Institute on May 12, 2021 6:44:51 PM

How would you characterize the success of your medical office? Is it a steady flow of patients, low denials, providers that take an active role in the business, a great clinical and administrative team? How about the financial health of the practice? It’s hard to guide the ship in the right direction when you are too busy plugging holes in the galley.

Read More

Topics: Practice management, Practice cash flow, medical practice issues, financial management, patient billing, patient collections

Subscribe Here!

Recent Posts

Posts by Tag

See all