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Outsourcing RCM
As the healthcare industry continues to grow in terms of capacity and complexity, there is one thing that clinics and private practices have in-common; the need for an efficient revenue stream. For many healthcare administrators this presents a bit of a dilemma since, to provide quality care and secure a reliable revenue cycle, they must wear two very different hats.
Lean Processes
The increasing competition in private practices puts a significant burden on your shoulders. You’re no longer just required to deliver excellent results but you also want to cut on costs by increasing efficiency to maximize resources.
Doctor and Nurse at Computer
According to a recent report, the trend for hospital physician employment may not be as beneficial to hospitals and physicians as some previously thought. Although there may be some advantages for physician groups to be owned by a hospital, by and larger there are numerous of reasons such an arrangement may not be the best one.
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 […]
Study and Survey
A recently released study from the Office of the Inspector General (OIG) of the US Department of Health and Human Services focused on improper Medicare payments for evaluation and management (E/M) services. E/M services include visits to non-physician and physician practitioners that aim to manage and assess a patient’s health.  In 2010 Medicare paid $32.3 billion for all E/M […]
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?
credentialing
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.
Why are my receipts down
A healthy revenue stream is the lifeblood of any healthcare practice, but with so many variables in play, maintaining a steady flow of incoming revenue can be a challenge. It’s situations like this which call for investigation into the practice’s revenue cycle management. 
Stethoscope on Cash Graphic
On January 30th, the Centers for Medicare and Medicaid Services (CMS) released financial figures which showed savings of approximately $380 million.  These savings, according to HHS secretary Kathleen Sebelius, could be directly attributed to various Accountable Care Act and Bundled Payment initiatives.
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 […]
Payor Contract Compliance
If you are a practicing physician in this market, you may wonder why you are working long hours and seeing as many patients as you can, yet the amount of money you are collecting seems to be decreasing.  You cannot identify the problem and it seems as though your billing system is working.  Bills are […]
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 […]