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Some excellent articles on protecting and improving your practice profitability have been published recently; here‘«÷s a selection of some we thought would be useful to you.

The Top 3 Reasons Your Claims Get Denied
There are plenty of reasons an insurer might deny your claims, but the most common billing errors are also the simplest and easiest to correct. Here are the top 3‘«™ Read More

Protect Your Practice from Reimbursement Rates and Abusive Payment Tactics
Financial challenges are the top concern in practices today. One of these challenges lies in the obligations defined through physician contracts. If you are one of those practices hard pressed to find a file drawer with all of the original agreements, addenda, and rates associated with reimbursement, you may end up with rates that do not even cover the cost of bringing patients through the door‘«™ Read More

Keep Your Patients Safe from Banned Healthcare Workers
The U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) wants to be sure you don‘«÷t employ excluded individuals to care for government-insurance patients. They are cracking down‘«™ Read More

Don‘«÷t Overlook an Opportunity for Loss
Every practice has its opportunity for loss.?ŠKeeping track of your money is a big job, and who is going to make sure it‘«÷s handled honestly? You can hope for employees with the highest integrity and for those who would do anything to make sure your office is as successful financially as it can be.

Still, theft happens‘«™ Read More

Fighting For Provider Revenue
In this insightful article, author Ken Congdon discusses the fact that healthcare reform, reimbursement cuts, sequestration, and RAC and Meaningful Use audits are new financial challenges cutting into provider revenue. He looks at ways to cope, advising physicians that:

1. Lean management is essential to reshaping financial processes
2. Focus on perfecting front end collection

He writes that ‘«£Of all the financial pressures currently facing healthcare providers, it seems like the biggest concern among many is effectively addressing the expected rise in patient financial responsibility.‘«ō

Read the full article now at

Stop Losing Revenue From 5 Common ASC Billing Mistakes
Here are five common mistakes made in ambulatory surgery centers (many applicable to other specialties as well) that result in increased denials and decreased revenue:

1. Mismatching fee/service invoices.
2. How to bill hardware or implant removals.
3. Not knowing coding changes, such as for excision of skin and soft tissue lesions.
4. Not filing claims on time.
5. “Defaulting” to 100 percent in-network participation.

Read the full article at

CMS: Clearinghouses Can Provide Limited ICD-10 Assistance
CMS released information to clarify the role of clearinghouses in assisting the transition to ICD-10, saying that clearinghouses should not be expected to provide the same level of support for ICD-10 as they did for the HIPAA Version 5010 upgrade‘«™ Read More

4 Reasons ICD-10 is Important to Healthcare
As the burden of the ICD-10 transition wears on, CMS reminds providers of the new code set’s importance to medicine, offering four reasons why ICD-10 matters:

1. It advances healthcare and eHealth initiatives. ICD-10, along with other federal programs, aims to provide greater interoperability, data sharing, quality measurements and clinical outcomes.
2. It captures medical advances.
3. It improves data for quality reporting. The more detailed code set naturally provides better data to measure outcomes and quality.
4. It improves public health research, reporting and surveillance.


5 Tips to Negotiate More Beneficial ASC Payor Contracts for Ophthalmology
Stephen Rothenberg, JD, a consultant with Numerof & Associates, Inc., discusses how ambulatory surgery center leaders can negotiate more beneficial payor contracts for ophthalmology procedures and the outlook for eye surgery as a specialty in the future‘«™ Read More

Is Your A/R Costing You More Than You Realize?
As more employers adopt insurance plans with higher deductibles as a way to better manage and save on employee healthcare cost ‘«Ų patients seeking surgical procedures are facing higher out-of-pocket costs, including increased co-pays and deductibles. Although billing patients and maintaining accounts receivable has been a widely used and accepted method of helping patients manage fees, it can cost your ambulatory surgical center more than you may realize‘«™ Read More

4 Tips for Finding Overlooked Revenue Sources in Healthcare
At the Becker’s Hospital Review Annual Meeting in Chicago May 10, Vince Pryor, CFO of Edward Hospital in Naperville, Ill., and Bruce Shapiro, senior vice president of operations at The CCS Companies, parent company of CCS Revenue Cycle Management, discussed commonly overlooked revenue sources.

“I don’t think you can go into a revenue cycle and not find at least 1 or 2 percent,” Mr. Pryor said. “There’s always something you can work on.” Read More

37 Statistics on What Providers Think About Bundled Payments
The majority of physicians and hospitals say bundled payments have the most potential to improve healthcare affordability rather than patient-centered medical homes or accountable care organizations, according to survey results from Booz & Company. ?ŠRead More

6 Biggest Reasons Provider Business Strategy Will Fail
Scott Regan, Founder and CEO of AchieveIT, gave a presentation at the Becker’s Hospital Review Annual Meeting in Chicago on May 10, 2013, titled “The 6 Biggest Reasons Your Strategy Will Fail.” Review those reasons now‘«™ Read More

Are Your Vendors Violating HIPAA? Why Internal HIPAA Compliance May Not Be Enough
We have recently assisted several healthcare provider clients that have discovered that their business associates had allowed protected health information of the provider’s patients to be improperly disclosed in violation of the Health Insurance Portability and Accountability Act of 1996. Specifically, the providers entrusted their patients’ PHI to a business associate, and the business associate did not appropriately protect it‘«™ Read More

Get Your 10 Electronic Prescriptions (eRx) Done Before June 30th to Avoid a 2% Cut in Medicare Payments in 2014
The deadline is fast approaching for both individual eligible professionals (EPs) and group practices participating in the Group Practice Reporting Option (GPRO) to complete their required number of electronic prescriptions. If you are an EP or an eRx GPRO participant, you must successfully report as an electronic prescriber before June 30, 2013 or you will experience a payment adjustment in 2014 for professional services covered under Medicare Part B‘«÷s Physician Fee Schedule (PFS.) Read More

Credit Card on File in Action: Changes for Patients and Employees
At Manage My Practice, we are big proponents of the credit card on file system as a road to financial viability. This program changes your patient collections from a back-end collection program to a front-end collection program, effectively collecting 95% of the patient responsibility within 45 days of the service. Read More

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