Robust RCM Systems: Keys to Effective Coding, Billing and Collections

Jeff GruberJuly 25, 2023

Effective coding, billing and collection processes are vital to ensuring timely and accurate payment for practice services. In the absence of strong procedures and systems, you put your medical group's financial stability at risk.

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Non-compliant Payers: “Hello, CMS, Are You Listening?”

Dr. Ronald HirschMay 2, 2023

As you may know, several payers have adopted a policy that they will review hospital billing for facility fees for emergency department visits, and will use their proprietary tools to automatically downgrade such visit codes based on the diagnoses and services listed on the claim. But as nearly all surely know, this is not compliant ...

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Group Practice Journal: Work Smarter Not Harder - Emerging from the Pandemic Positioned for Growth and Stability

Vijay KotteSeptember 1, 2021

Rebounding from the extreme financial strains of COVID-19 requires a hard look at your revenue cycle and how it is maintained: Where are the opportunities to improve patients’ experiences and address their demands to “go contactless”? How can your revenue cycle and front-office teams work efficiently? Are you maximizing every revenue ...

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Moving Past Revenue Cycle Recovery to Achieve Financial Resilience

Nicole ShinglerFebruary 8, 2021

After a fairly predictable start, 2020’s unforeseen turn into a yearlong (and counting) pandemic created a torrent of financial and clinical challenges for hospitals and health systems. Reduced volume, increasing care complexities and an uncertain economy still remain in 2021 as hospitals continue working toward financial recovery. It won’t be ...

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Three Best Practices to Improve Reimbursement Via Coding

Yvonne RussellNovember 6, 2020

2020 is beginning to wind down, but COVID-19’s financial impact on physician practices isn’t. As The Washington Post recently stated, “many of the doctors…who form the backbone of front-line care are barely hanging on,” and ...

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Physicians Practice: Leveraging CDI for Post-COVID Financial Recovery

Brian SmitOctober 2, 2020

In the wake of COVID-19, physician practices faced a myriad of challenges creating a contactless and consumer-friendly patient experience, ramping up telehealth services, and transitioning non-clinical staff to work from home. Given these priorities, it’s understandable that clinical documentation improvement, or CDI, didn’t see much ...

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Independent Providers: How to Reduce Four Billing and Coding Errors

Jessica ShortDecember 9, 2019

For modern medical practices, financial health is often challenged due to shrinking reimbursements and increased scrutiny over coding practices. Although medical billing and coding errors are usually from minor mistakes, these common errors can add up to a lot of lost revenue over the years and, for smaller practices, failing to ...

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Four Questions You Should Ask Your Revenue Cycle Partner

R1 RCMSeptember 16, 2019

With updated rules and a newly pruned reimbursement landscape, the uncertainty associated with the future of healthcare has not been made any clearer. In fact, the current environment may have seemed to muddy the waters further, making it even more difficult for healthcare institutions and independent clinicians to understand what is required ...

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Recognizing the Importance of Innovation in Medical Coding

R1 RCMNovember 8, 2018

A significant portion of operational impact, support and overall compliance in healthcare services starts with coding. Medical coding helps the healthcare industry transform diagnoses, physician’s notes, and various medical services into a common language that ensures both the patient, provider and payers receive the best end-to-end ...

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2019 Medicare Physician Fee Schedule Proposed Rule

R1 RCMJuly 24, 2018

On July 12th, the Centers for Medicare and Medicaid Services (CMS) released the 2019 Medicare Physician Fee Schedule (PFS) proposed rule. This annual update to the regulation makes changes to Medicare Part B reimbursements for services covered under this and other outpatient payment models.

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