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How to Avoid Pitfalls in the Provider Credentialing

Patrick Dougherty

Just a couple of decades ago, getting credentialed with an insurance panel wasn't so critical to a practice's success. Patients didn't expect that every doctor would accept their insurance, not every service was covered by insurance (think chiropractic care, mental health, and substance abuse, for example), and most insurance plans offered some out-of-network benefits so you could grow your practice even without enrolling in every plan. 

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Topics: Medical Practice Revenue

How to Check the Financial Health of Your Medical Practice

Patrick Dougherty

When doctors think of vital signs, they're usually thinking of patients, not the metrics and statistics that indicate whether the practice is healthy and financially viable. But for practice administrators or office managers, these financial vital signs are the key to understanding the revenue cycle management and its strengths and vulnerabilities. 

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Topics: Medical Billing

Medical Practice Administrator Can Improve Medical Billing Processes

Patrick Dougherty
The medical practice administrator has an extensive list of responsibilities covering everything from policy and procedures to hands-on management of providers and staff. Ultimately, however, the manager is accountable for the practice's bottom line—keeping costs under control and maximizing revenue through efficient billing and collections procedures.
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Topics: Medical Billing

Medicare Final Rule: What Happens If I Find an Overpayment?

Harold Gibson

Have you received any Medicare overpayments? If you don't know (if you're not examining your claims data and doing regular internal compliance audits), you may be in for an unpleasant surprise. In March, CMS issued a final rule regarding Medicare overpayments, and while the rules don't necessarily mandate a formal internal compliance regime, many health law experts think such a strategy is implicitly implied, given that CMS calls for a level of diligence that includes “proactive compliance activities to monitor claims and reactive investigative activities undertaken in response to receiving credible information about a potential overpayment."

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Topics: Medical Practice Revenue

Are You Spending Too Much on Medical Billing Services?

Patrick Dougherty

Whether you're outsourcing your billing or keeping it in house, there's always a nagging question whether you're spending too much on getting paid. While it's impossible to equivocally state what's best for every practice, there are some basic cost analyses you can compare to see how your practice's billing expenses compare and whether you're paying too much for your collections or worse yet, leaving too much uncollected revenue on the table. 

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Topics: Medical Billing

About this blog

A place for physicians and other healthcare RCM stakeholders to share and discover information about everything related to medical billing and ways to increase revenue.

Established in 2002 by a group of physicians, we are a national provider of medical billing services to group practices, clinics, and individual physicians. We also specialize in provider credentialing, payer contract reviews and medical coding for a wide range of clients - from solo practitioners to multi-site, multi-specialty practices. 

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Which Medical Billing Option Best For Your Practice?  

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