Category Archives: Practice Management

What We’re Reading – Getting prepared for ordering and referring denial edits

Are you aware that, effective May 1, 2013, CMS will deny claims if the ordering and/or referring providers are not enrolled in the Medicare system? This will affect all Medicare Part B covered services, durable medical equipment, orthotics, and supplies … Read Full Post

Tagged claim edits, medicare part a hha, medicare part a home health agency services, medicare part b, npi registry, ordering and referring denial edits, ordering provider, pecos, referring provider |

Do EHRs Contribute to Coding and Payment Inaccuracies?

Many providers have touted the electronic health record (EHR) as the magic bullet to improve billing accuracy. However, according to the Center for Public Integrity, “Medicare regulators also acknowledge they are struggling to rein in a surge of aggressive — … Read Full Post

Tagged billing and coding accuracy, ehrs, electronic health record regarding billing, electronic health record regarding coding, electronic health records, evaluation and management, fraudulent documentation and billing, medical practices, physician practices, physicians documentation |

What We’re Reading – 7 Ways to Attract New Patients to Your Medical Practice

Virtually all providers are looking for ways to grow their patient base. The challenge in these economic times is to do it without spending a fortune on marketing and advertising services. This article explores less expensive and even free options … Read Full Post

Tagged attracting new patients, getting new business, growing your business, increase traffic to your practice, medical practice, new patients, physician practice, social media |

Is Your HIPAA Program on ‘Auto-Pilot?’ Security Rule Requires Continuous Oversight

Most healthcare providers automatically think about privacy issues when the HIPAA law comes to mind and seem to have gone on ‘auto-pilot’ when it comes to protecting privacy. It’s not uncommon to see offices being mindful of the visibility of … Read Full Post

Tagged electronic health record system, electronic phi, electronic protected health information, hipaa, hipaa privacy rule, hipaa program, hipaa security rule, home health agencies, protected health information |

Medicare ACOs: Risk Adjusted Reimbursement’s Mathematical Impossibility (Part 5)

So far in this five-part series on Medicare ACOs, we’ve explored the basics of the concept, the patients’ participation, the fundamentals of reimbursement as well as the provider’s role and incentives. Recall that we explained in an earlier section that … Read Full Post

Tagged aco physicians, center for medicare and medicaid services, managed care plans, medicare acos, medicare advantage plans, medicare fee-for-service, risk adjusted reimbursement |

Medicare ACOs: Healthcare providers and the ACO (Part 4)

The ACO contemplates a paradigm where the entire continuum of care (from physicians to hospitals to rehab centers and everything in between) is coordinated on the beneficiary’s behalf to deliver quality and cost-effective care. In the fourth installment of our … Read Full Post

Tagged center for medicare and medicaid services, fee-for-service methodology, healthcare providers and the aco, medicare acos, medicare beneficiaries and the aco, primary care physicians, quality and cost-effective care, reimbursement |

What We’re Reading – Strategic Planning for Your Medical Practice

The words ‘strategic planning’ usually conjure up a mega-conglomerate with multiple committees and planning gurus, not a small to medium-sized medical practice, right? Wrong. Physicians and decision makers need to – at least annually – stop, look at environmental factors … Read Full Post

Tagged create action steps, medical practice, physician practice, strategic planning |

Medicare ACOs: The Basics of Financing (Part 3)

In the first two parts of this five-part series, we looked at some background information on ACOs as well as the assignment of Medicare beneficiaries and the limitations on their choices. In essence, there are no limitations on provider choice … Read Full Post

Tagged aco financing, aco's model, center for medicare and medicaid services, cms, health care services, managed care contracts, medical necessity, medicare acos, medicare beneficiaries and the aco, the basics of financing for medicare acos |

Medicare ACOs: Medicare beneficiaries and the ACO (Part 2)

Last time, we reviewed some of the background information concerning ACOs and the objective of this care delivery model. In this installment of the five-part series, we will begin where health care truly starts: the patient. Medicare beneficiaries will be … Read Full Post

Tagged accountable care organizations, medicare acos, medicare advantage plans, medicare beneficiaries and the aco, medicare beneficiary, primary care physicians, primary care services |

Medicare ACOs: Stroke of Genius or Mathematical Impossibility? (Part 1)

The big buzz these days is about ACOs. In this series, we will discuss some of the features of Accountable Care Organizations and explore the overall question: Are Medicare ACOs a stroke of genius or a mathematical impossibility? This five-part … Read Full Post

Tagged accountable care organizations, background of medicare acos, fee-for-service, health care system, ma mso or ipa, medicare acos, medicare advantage, medicares shared savings program, physician groups |