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5 Ways to Prevent Claims From Being Denied and Improve Collections

Patrick Dougherty

Getting claims paid in a timely manner and as efficiently as possible is vital to the strength and longevity of your medical practice. According to some estimates, it costs medical providers an average of $6.50 to file each claim with an average of 5 to 10 percent of these being denied. When claims are re-submitted, the cost to do so jumps as high as $118. Up to 65 percent of denied claims are never even re-submitted at all. 

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Topics: medical claim denials, claim denials

Medical Coding Changes in 2020 and Beyond

Harold Gibson

There are numerous long-awaited requested changes and additions to codes from both the AMA and CMS that can be expected for the year 2020 and beyond. Many of these pertain to distance medicine and the technologies necessary to provide such services. Below are some more significant changes ahead for providers and their coding staff.

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Topics: Medical Coding Changes in 2020

Telemedicine Reimbursement: Remote Patient Monitoring and Updated CMS Codes

Harold Gibson

Over the past year the Centers for Medicare and Medicaid Services (CMS) has initiated significant changes in how remote patient monitoring (RPM) and other forms of telehealth and telemedicine will be coded and billed. Private payers are following suit in enacting their own billing policies and guidelines. Some states still lag with implementing Medicaid updates and other guidelines but more are starting recognize that transportation expenses and other applicable factors are impacting access to healthcare. Here, we discuss some of the most significant changes including updated CPT codes that telehealth providers and their billing staff need to know.

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Topics: Telemedicine Billing, remote patient monitoring, Telemedicine Reimbursement

7 Best Tips for Hiring Clinical Staff in a Small Medical Practice

Patrick Dougherty

Most physicians and small medical practice administrators understand the importance of hiring qualified staff. Not only does having the right people make a difference in how smoothly everything runs, but it can also make a huge impact on your patients. But how do you find the right people and—more importantly—how do you find ways to afford them? Here are seven of our best tips for hiring clinical staff in a small medical practice.

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Topics: Hiring clinical staff

Medical Auditing Can Help Increase Profitability

Patrick Dougherty

Nearly every medical practice faces auditing from governmental agencies like the CMS. An equally important auditing process, however, is one that your medical practice takes on itself. 

Medical Auditing Explained

The main reason to perform a medical audit is to improve the financial health of your medical practice. An audit evaluates medical codes selected for diagnosis and procedures to ensure that they are supported by documentation from the physician. Any weaknesses revealed identify training opportunities that can be applied to your medical team

Second reason for medical practice owners and administrators to perform an audit is to make sure  deliver the highest quality health care to patients, your medical team must rely on patient health records. Ensuring that this documentation is complete, accurate and clear is the purpose of engaging in a medical audit. It serves to highlight those areas that need to be corrected and/or improved. 

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Topics: Medical Billing Audits, medical billing analysis

About this blog

A place for physicians and other healthcare stakeholders to share and discover information about everything related to running efficient medical practices.

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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