Category: Private Practice

Can an ACO Benefit Independent Physicians?

An Accountable Care Organization (ACO) is a voluntary association of healthcare providers that bases physician reimbursement on performance quality and outcomes in order to lower overall costs. This method incentivizes physicians to deliver higher-quality care at an affordable cost, and is replacing the traditional fee-for-service model that has dominated healthcare in the past. The Medicare

Medicare’s New ‘Preclusion List’

By way of background, let’s start with a short Medicare primer. The federal Medicare program is a government health insurance program that pays for certain health care services for individuals who are 65 or over and have paid into Social Security and Medicare through payroll taxes for the required periods; certain younger people with disabilities;

What Physicians should know about Value-Based Payment Models

Payment models have undergone numerous and frustrating changes over the past few years, and the implementation of the value-based reimbursement model is no exception. Physicians submitting claims to Medicare have likely experienced the changes relating to this payment model. Value-based reimbursements are/were intended to compensate providers based on performance and guidelines focused on improving patient

Billing Process Tips that Increase Revenue

Treating patients is your job. So too is getting paid. Unless you belong to a large medical group, chances are that your staff is taking care of billing for you. Small practices are especially at risk of delayed payments for a variety of reasons. Approximately 83% of physician practices with fewer than five practitioner states

Value of Outsourcing Your Billing Services

You have a busy medical practice with a steady flow of patients. You should be making a profit, but for some reason you’re not. Instead of waiting weeks for payments, you wait for months.  Why? In many physicians’ offices, billing tasks are relegated to a staff member not trained or certified to provide such services.

Identify your Practice’s Billing Challenges to Reduce Delays and Increase Revenue

Physicians have enough on their plate without having to micromanage back-end office staff. That often happens when billing challenges start digging into your bottom line. If your office staff doesn’t keep up with coding changes, timely submission and requests for additional information with claims, or uses the wrong billing codes for reimbursement, your revenue cycle

Manual Claim Checks – What’s at Stake for your Organization?

Does your practice manually contact payers to check your claim status? Are you aware that doing so costs roughly $7 per attempt? Your revenue cycle management processes are vital to the financial health and wellness of your practice. Poorly managed handling of claim status inquires costs you not only money, but precious time. A few

Medical Billing Challenges for Private Physician Practices

A private medical practice’s success is reliant on revenue cycle management, accurate and timely claims submissions, and prompt reimbursement from insurance carriers. That said, it’s not unusual for a private practice physician to have to wait weeks or longer to receive payments. Even when reimbursement is received, it’s often much less than they charge for

Study: Patients Prefer Electronic Billing for Healthcare Services

According to a recent survey by Waystar and HIMSS Analytics, the majority of hospitals, health systems, and outpatient facilities continue to bill patients with paper statements. Although paper billing is a standard practice, more than half of the 1,000 patients surveyed said that they prefer electronic billing and payment. Electronic billing aligns with how patients

Study: 30% of Patients Leave Doctor’s Office After Long Waits

Waiting Room

A recent study by Vitals showed that up to 30% of people end up leaving without seeing their physician because the wait is too long. Each patient who leaves due to frustration could be a missed opportunity for revenue for the doctor’s office. In fact, 1 in 5 patients reported changing their doctor because of