Do you have to return plan overpayments? The short answer is, yes. Of course, you must return money that isn’t yours. In fact, to be compliant with Medicare and most commercial payers, once you discover an overpayment, you’ve got to refund it within 60 days. That's the word from Michael J. Sacopulos, JD, founder and CEO of the Medical Risk Institute. "Sadly, I still speak … [Read more...] about 4-step plan to return overpayments
Increasing profits
Is it a recession or not? The answer may surprise you
By Lynne Curry My in-box filled with questions after I posted a Recession Fears Loom blog. Readers asked how I made sense of the different views voiced by economists and politicians. As a medical office manager with responsibilities around staffing and profitability, you are probably watching to see which way the economy goes. Here’s the background, and my answer to “are we … [Read more...] about Is it a recession or not? The answer may surprise you
Submit your Promoting Interoperability measures and improvement activities
The Centers for Medicare & Medicaid Services (CMS) reminds you to submit Promoting Interoperability measures and improvement activities for consideration for future years of the Merit-based Incentive Payment System (MIPS). The MIPS Annual Call for Measures and Activities process allows clinicians, professional associations and medical societies that represent clinicians, … [Read more...] about Submit your Promoting Interoperability measures and improvement activities
Not ready for clinical analytics? Try operational analytics
By Aaron Brandwein Up until this point, our discussion about analytics in healthcare has revolved heavily around clinical analytics—and understandably so. The potential promises it brings to the table are huge, especially when you look at things like predicting clinical outcomes, identifying the risks for diseases and ailments, and helping practitioners choose better treatment … [Read more...] about Not ready for clinical analytics? Try operational analytics
How to choose a healthcare analytics provider: A checklist
By Kevin Keenahan An effective analytics provider promises to bring novel data sets and insights to the table, optimize workflows, build efficient processes, and deliver superior financial returns in evolving value-based payment models. The challenge for buyers The “analytics” is a complex, nebulous family of functionality and the marketing noise surrounding many … [Read more...] about How to choose a healthcare analytics provider: A checklist
Denial management: the missing ingredient in revenue cycle management
By John McDaniel The blueprint for effective Revenue Cycle Management (RCM) is complex in today’s healthcare environment. When we map out the RCM process, it includes the following steps: Patient scheduling and registration Insurance eligibility and benefit verification Collection of copayments and deductibles at time of service Claims submission Remittance processing … [Read more...] about Denial management: the missing ingredient in revenue cycle management
5 tech resources improving medical practice efficiency this year
By Alison Foster bio There was a notable increase in the adoption of healthcare technology by practices and providers in 2020. This continues in 2021, especially as the COVID-19 pandemic shows no signs of letting up. Many practices are short on both human and financial resources and need to increase efficiency to the maximum. Here are some forms of healthcare technology you … [Read more...] about 5 tech resources improving medical practice efficiency this year
Medicare payment upped for COVID-19 vaccine
The Centers for Medicare & Medicaid Services (CMS) has increased the Medicare payment amount for administering the COVID-19 vaccine. This new and higher payment rate will support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting … [Read more...] about Medicare payment upped for COVID-19 vaccine
The physician enterprise model: a non-employment alternative
By John W. McDaniel bio Hospitals are seeking new and innovative ways to affiliate with physicians that differ from tactics used in the 1990s, These new relationships involve a more formal type of relationship with physicians, which might reflect lessons learned through previous less‐than‐satisfactory relationships. Most hospitals have physician integration strategies as a … [Read more...] about The physician enterprise model: a non-employment alternative
The new paradigm for physician compensation: payment for value/quality v. volume
By John McDaniel bio How will physician compensation arrangements be impacted by quality incentive payments with respect to determining Fair Market Value and commercial reasonability? The enactment of the Medicare Access and CHIP Reauthorization Act (MACRA) in November 2016 set forth future options for payment from Medicare, those being participation in the Merit‐Based … [Read more...] about The new paradigm for physician compensation: payment for value/quality v. volume