Billing & Reimbursement

Impacts of Payer Mix Shift
In order to maintain a healthy revenue stream, it is key that your practice has a well-balanced mix of payers. If your revenue stream seems to be sagging it could be that your payer mix has shifted in a negative direction. That is, you may have seen patients with coverage from lower, poor, or slow payers.  Here are some things […]
Time for Orthopedic Billing Patients
When it comes to collecting payments for orthopedic services rendered, time is the enemy.  As time passes, the likelihood for reimbursement decreases. What can a practice do to ensure the collection of payments?
Orthopedic practices often suffer from revenue stream issues stemming from a number of different causes. The reimbursement process is complicated enough without holding it back due to issues within a practice, and yet there are common concerns which plague orthopedic practices if not carefully monitored. One of these issues is the credentialing process for providers.
Piggy Bank Graphic
The Bundled Payments for Care Improvements (BPCI) initiative of the Centers for Medicare and Medicaid (CMS) seeks to improve the quality of care – the outcome – while limiting the cost of the services provided for a particular episode of care for specific patients.  The approach is not unlike that taken by CMS in the […]
Stethoscope on Change
Eliminating claim denials is a crucial aspect to revenue cycle management.  Successful healthcare providers have streamlined operations and made the revenue cycle more efficient.  They understand that every step counts when it comes to securing reimbursements and obtaining revenues for their services.  An operation that lacks efficiency, the necessary staff skill set or effective processes […]
Doctor Looking at X-Rays
Using the practices referenced above can go a long way toward ensuring that any practice’s radiology billing process will become more streamlined and efficient, thus allowing for greater success for the healthcare provider in question Accurate and efficient radiology billing can prove tricky, especially with so many factors influencing the final outcome.  Still, maintaining a […]
Outsource Graphic
As a healthcare professional, your focus and strength should be on your patients and their treatment plans rather than on managing your office financials.  In looking at how you handle medical billing, you may be tempted to stay with what you have in place rather than spend the time to make a change.  But in […]
Wrong Graphic
The process of switching over to ICD-10 has caused a lot of stress in healthcare circles even before many companies begin to make the change.  While the repeated delays in the mandate to convert record-keeping processes bring a relief to some, they also cause more confusion. These delays have generated a number of myths that […]
Cutting Costs Graphic
Stagnant reimbursements and rising costs make finding ways to improve efficiency a critical initiative for healthcare providers.  Documentation costs for physician services can represent a very significant expense.  Better billing processes and more efficient management of electronic health records (EHRs) could help turn the tide. Upcoming changes to billing and coding, along with the implementation of […]
Operating Room
With more and more orthopedic procedures being done on an outpatient basis, proper coding of those procedures is one of the most important elements for today’s ambulatory surgery centers (ASCs) to consider. This is especially true in light of the projected changes in procedure coding resulting from implementation of ICD-10.  Ambulatory surgery centers have certain procedures that they […]
Female Doctor with Computers
The Centers for Medicare and Medicaid Services issued what they believe is the final version of the Place of Service rule for physicians effective April 1, 2013.