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Private equity deals can mean quick cash now and later – for the right kind of practice

03/26/2018

If want to get a private equity deal for your practice, you’ll have to demonstrate high future revenue potential and do a lot of due diligence before you even get to the table. But that work could mean a big payday for the physicians and their partners who own the practice.

3 last-minute tips to avoid a MIPS penalty for the 2017 reporting year

03/26/2018

by: Richard Scott

The reporting deadline for the inaugural merit-based incentive payment system (MIPS) year is coming up fast — it’s March 31 for nearly all reporting methods, including claims and electronic health record (EHR) reporting — but that may leave enough time for a final shot.

Some payers accept consult codes — but be sure that’s what you did

03/26/2018

by: Roy Edroso

Question: For new patients who are not on Medicare, our office uses the office consultation codes 99241-99245 if referred by a doctor and 99201-99205 if self-referred. The E/M criteria are met for time, history and exam for all codes. Is our use of the consultation codes correct? Is it commercial carrier dependent?

Some providers continue to bill Medicare for non-covered consultation codes

03/26/2018

by: Richard Scott

Despite Medicare’s decision to no longer cover a suite of five outpatient consultation codes (99241-99245) nearly a decade ago, providers continue to pursue a mission impossible and seek payment for thousands of visits per year.

Document thoroughly, wrap in specific history and exam when prescribing CPAPs

03/19/2018

by: Richard Scott

Don’t overlook Medicare’s stringent documentation requirements when referring patients for continuous positive airway pressure (CPAP) devices or you may get caught up in denied claims that leave your patients without coverage.

DOJ memos reduce danger of FCA prosecutions – but watch for this hidden threat

03/19/2018

by: Roy Edroso

While the Department of Justice and its prosecutors are racking up big False Claims Act (FCA) settlements in health care, two recent DOJ memos may take some of the heat off.

4 small changes that can trim EHR screen time, increase patient interaction

03/19/2018

by: Roy Edroso

As a new study finds providers’ attention to electronic health record (EHR) screens outstripping attention to patients, look to small efficiencies to help restore the balance.

CCM and TCM: 4 tips to craft a seamless care management coding plan

03/19/2018

by: Richard Scott

Sharpen your care management coding by adhering to Medicare’s specific service requirements and take advantage of non-face-to-face care you already provide to your patients between office visits. Doing so will provide a revenue opportunity and help you maintain patient contact during critical times of illness.

Growth, rewards in CPAP-related billing — but watch those denials

03/19/2018

by: Roy Edroso

Use of codes related to sleep apnea and continuous positive airway pressure (CPAP) continues to grow, but denial rates show providers have to be careful.

Use role play, scripts and empathy to keep patients paying and happy

03/12/2018

by: Roy Edroso

While it’s important in the era of high-deductible insurance plans to get patients to pay their bills in a timely manner, experts say you don’t have to hassle or alienate them — in fact, training the patient to pay is as important as training the staff to ask properly for payment.

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