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Practice Management Alert

Revenue:
Improve Provider, Coder, Biller Relations, Improve Outcomes and Revenue
Three different roles, the same shared goals. In her HEALTHCON Regional presentation “D... Read more
Coding:
Let These 3 Tips Lead You to New vs. Established Patient Clarity
You can collect more for new patients — but check these guidelines first. What's the di... Read more
Staffing:
Understand the 5 Challenges Remote Workers Face
Craft effective policies to maintain compliance. Remote workers face several challenges ... Read more
Reader Questions:
Try ‘Office Hours’ to Boost Employee Focus
Question: One of our practice's expert coders is very generous with her knowledge and... Read more
Reader Questions:
Understand NPI Types
Question: Are there different kinds of national provider identifiers (NPIs) for indiv... Read more
Reader Questions:
Heed This Insight on Documentation Requests for CERT Reviews
Question: Our practice is currently in the middle of a Comprehensive Error Rate Testi... Read more
MPFS:
Here’s the Big News in the 2025 Proposed Rule
Big surprise: Another rate cut is coming. The Centers for Medicare & Medicaid Service... Read more
Reimbursement:
Avoid These 8 Common Medicare Billing Errors to Keep Pay Flowing
Watch those dates of service, MAC addresses, and more. Your provider documented a claim ... Read more
E/M Coding:
Bolster Your Distinct Time Billing Knowledge
Remember to bill with only one provider's number. Both the Centers for Medicare & Me... Read more
Reader Questions:
Include These Elements on Orientation and CE Lists
Question: How can I make sure my nonclinical staff are trained, especially on crucia... Read more
Reader Questions:
Use This Checklist for Medical Necessity
Question: What are the core tenets of documenting and illustrating medical necessity?... Read more
Reader Questions:
Distinguish NCD From LCD
Question: What's the difference between a national coverage determi­nation (NCD) and... Read more
Best Practices:
Dissect Your Workflow to Streamline Operations
Hint: Patient satisfaction is all about setting expectations. In a medical practice, orde... Read more
News You Can Use:
Hear From Those Affected by the Change Healthcare Outage
Reinforce your skills with paper-based claims. More than four months have passed since ... Read more
More News:
Feds Focus On Physicians In June Enforcement
Prescription fraud, E/M upcoding, and more factor in latest settlements. You might have n... Read more
Modifiers:
Know These Modifier QW Dos and Don’ts
Hint: Check the CLIA list every time you're submitting a new lab test. Some coding modi... Read more
Reader Questions:
Beware of Licensing Obligations
Question: My practice has received communications from the American Medical Associati... Read more
Reader Questions:
Patients May Need to Choose Between Benefit Programs
Question: One of our patients mentioned to a nurse that he was receiving continuing g... Read more
Reader Questions:
Lean on Documentation for E/M of Services Not Actually Performed
Question: Can we count a provider's efforts to counsel a patient against a test as ev... Read more
Best Practices:
Try These Tips for Boosting Financial Literacy
Hint: Make sure you involve physicians, so they understand the ripples of their work. Ma... Read more
Continuing Education:
Use This Guidance to Improve Your Coding Education Process
Check out these tips for more effective onboarding. Coding education is an ongoing effor... Read more
Audits:
Establish Practice Protocols for Addressing A TPE Audit
Hint: Look at your MAC's focus to troubleshoot internal issues. Whether you've already s... Read more
Reader Questions:
Find Flexibility in Delegating Prior Authorizations
Question: If a patient's prescribed medication needs a prior authorization from their... Read more
Reader Questions:
Be Careful About Disclaimers on Records
Question: One of the physicians at our practice uses dictation software, and the vend... Read more
Reader Questions:
Get Clarity on Separate Procedures
Question: I've read that CPT® guidelines preclude coding some procedures together b... Read more
Best Practices:
Find Some Light in the Prior Authorization Maze
Hint: Don't forget to keep track of denials so you can troubleshoot your processes. Healt... Read more
Cybersecurity:
Take These 3 Tips, Use AI to Speed Through Unprocessed Claims
Here's how to streamline your workflow intelligently. Revenue cycle teams handle thousand... Read more
Reimbursement:
Avoid These 8 Common Medicare Billing Errors to Keep Pay Flowing
Watch those dates of service, MAC addresses, and more. Your provider documented a claim... Read more
Reader Questions:
Focus on These Aspects of an Appeal Letter
Question: What information is crucial to include when I'm appealing a denied claim? ... Read more
Reader Questions:
Distinguish Medical Identity Theft From Other Types of Fraud
Question: Is medical identity theft a type of fraudulent claim? Minnesota Subscriber... Read more
Reader Questions:
Give Patients Tools to Boost Staff Morale
Question: How can I boost employee morale and keep track of all the great things my t... Read more
Reader Questions:
Get the Skinny on Medicare Overpayment Timeline
Question: We've heard that Centers for Medicare & Medicaid Services (CMS) says w... Read more
Best Practices:
Consider These Tips to Monitor Employee Productivity
Hint: Look at workers' records over a defined period of time. Practice managers know that... Read more
Documentation:
Study These Strategies for Setting Up a Solid CDI Process
Realize the benefits of regular self-audits. Comprehensive clinical documentation is the ... Read more
Training and Education:
Don’t Skimp On Sanction Policymaking, Feds Warn
Tip: Make employee training match duties. Stopping a data breach incident and retrievin... Read more
Reader Questions:
Sign-In Sheets Still OK
Question: One of the physicians in my practice demands we use a sign-in sheet—he says th... Read more
Reader Questions:
Rely on Addendums for EHR Mistake Corrections
Question: How should we correct a mistake in an electronic health record (EHR)? Montana S... Read more
Reader Questions:
Wearable Technology May Bring Peace of Mind
Question: I have several patients who suffer from epilepsy that is well controlled with me... Read more
Reader Questions:
Define Stable Condition
Question: Is there any difference between a chronic condition and a stable condition, espe... Read more
Industry News:
Did You Feel Shockwaves From the Blackcat Attack?
The cyberattack underscores the interconnectedness of U.S. healthcare. The Blackcat cybe... Read more
Revenue:
Capture These Tips to Stall Denials
Make sure your billing team feels empowered to communicate well. Denials easily cross th... Read more
Payers:
Acknowledge the Need for Strong Relationships with Payers
Getting glimpses of the payer experience is a good first step. While providers may not be... Read more
Reader Questions:
Bulk Up Your Documentation With M.E.A.T.
Question: What, exactly, does M.E.A.T. stand for in the medical context? Oregon Subs... Read more
Reader Questions:
Employ Protections for Patient Signatures
Question: In our recent risk evaluation, we discovered that the electronic signatures... Read more
Reader Questions:
Be Careful With Complexity for Undiagnosed Condition
Question: Does an undiagnosed new problem with uncertain diagnosis automatically mean... Read more
Back to Basics:
Delve Into ‘Medical Necessity’
Hint: You may not need to conflate medical necessity with clinical care. The phrase “me... Read more
E/M Services:
Find Clarity on Providing E/M Services for Medicare Beneficiaries
And remember: Other payers may adopt these guidelines, too. In many coding roles, knowing... Read more
Mythbusters:
Don’t Let the Internet Be the Wild West for Your Provider
Discover your responsibilities in protecting patient internet use data. Most websites co... Read more
Reader Questions:
Respond to Record Requests With These Tips
Question: What's the best way to respond to a documentation request from another physician... Read more
Reader Questions:
Explore Potential Outcomes of SDOH
Question: I know there's a huge push to document social determinants of health (SDOH) for ... Read more
Reader Questions:
Distinguish NCD From LCD
Question: What's the difference between a national coverage determi­nation (NCD) and a lo... Read more
Audits:
Take Preparations Now for TPE Resurgence
Don't risk making these common errors. The Centers for Medicare & Medicaid Services (... Read more
Best Practices:
Beware of Healthcare Workplace Violence
Look out for legislation and regulations that acknowledge dangers for healthcare personnel... Read more
Modifiers:
Find Clarity With These Modifier FAQs
Boost your modifier usage knowledge to avoid reimbursement woes or headaches from audits. ... Read more
Reader Questions:
Find CERT Info via Hub
Question: Are there any resources available to help folks navigate the Center for Me... Read more
Reader Questions:
Acknowledge HC3 Advice
Question: We've been shopping for new software for our healthcare practice and haven'... Read more
Reader Questions:
Don’t Discount Smartwatch Data
Question: I am training as a scheduler, and a patient called in saying that their sma... Read more
Managed Care:
Pocket This Managed Care Primer
Shore up your managed care know-how before the OIG comes knocking. The Office of Inspecto... Read more
HR Corner:
Don’t Let a Stark Violation Masquerade as a Gift
Establish and review policies, and make sure staff understand their responsibilities. Th... Read more
Modifiers:
Expand Your Knowledge of NCCI Edits
Hint: Understanding context is crucial information for accurate coding. Most coding sof... Read more
Reader Question:
Be Honest About Qualifying for Home Visit
Question: My provider wants to bill 99350 when performing a home visit via telehealth... Read more
Reader Question:
Think Beyond Reimbursement for Z Codes and Medical Necessity
Question: Do Z codes really affect reimbursement, or are they mostly designed to pad ... Read more
Reader Question:
Be Sensitive When Gathering Demographic Information
Question: I work as a scheduler and recently heard a colleague on the phone with a pa... Read more
Practice Management:
Maintain or Even Boost Practice Margins With These Tips
Rely on evaluations and engagement to bolster your healthcare business. “One of the thi... Read more
Practice Management:
Remember Copays are Contractual
Question: Can front desk staff waive copays at their discretion? For example, if a patient... Read more
Practice Management:
Read the Fine Print on Payer Policies for Medical Necessity
Question: Isn't preventive care implicitly medically necessary? Massachusetts Subscriber ... Read more
Practice Management:
Avoid These Common Documentation Shortcuts
Question: I know illegibility has historically been an obstacle to good documentation. My ... Read more
Practice Management:
Protect Your Practice From Potential Fraud
Training your office staff and correctly billing patients is key to avoiding fraudulent cl... Read more
Practice Management:
Use The Correct Tax Forms for Each Worker Category
Question: When hiring part-time or full-time staff, which tax documents do I need to use? ... Read more
Practice Management:
Prep Your Holiday Schedule With 5 Proven Fee-for-Time Billing Tips
Accurately collect for these fill-in providers, previously called locum tenens. With the ... Read more
Practice Management:
Don’t Change a Lab Order Without Authorization
Question: Our practice is submitting claims for lab orders and they keep getting denied. O... Read more
Practice Management:
Consider Government Scrutiny Before Offering Gift Cards
Question: Are doctors' offices allowed to give out gift cards or other gift-type incentive... Read more
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