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No insurance? Tag fees to your highest non-Medicare payers’ fees

03/26/2017

Question: What’s the best pricing policy for uninsured patients?

For some physicians, consolidation has its perks

03/24/2017

The number of solo and small practices continues to dwindle in the U.S., and the pace of consolidation is expected to quicken in the next few years as uncertainty and change continue to pressure independent practices. A number of factors are impacting the bottom line of small practices and physicians, including the high cost of medical malpractice insurance, the demands of health information technology, flat reimbursement rates from Medicare and Medicaid, and the potential for those flat rates to be reduced if a practice doesn’t meet quality reporting benchmarks.

Millions projected to lose insurance under GOP proposal; Verma takes over CMS

03/20/2017

by: Richard Scott

Estimates from the Congressional Budget Office (CBO) released March 13 convey a dire portrait of health insurance coverage should the American Health Care Act (AHCA) go into effect — 14 million fewer individuals would have coverage in a year’s time and about 24 million would lose coverage by 2026.

New ICD-10 e-cigarette abuse, heart attack codes coming for use Oct. 1

03/20/2017

by: Laura Evans, CPC

In mid-April, practices will get a first look at many — but not all — of the ICD-10-CM code changes that will take effect Oct. 1. That’s when CMS releases the changes as part of the proposed Medicare inpatient hospital payment rule.

4 areas where telehealth, though under-covered, can bring in revenue

03/20/2017

by: Roy Edroso

For most providers, reimbursement for telehealth is spotty at best, but look to these key programs that will pay you for the remote work while setting you up for future success.

Turn to secondary insurance, talking points to avoid CCM copay barriers

03/20/2017

by: Richard Scott

If cost-sharing for chronic care management (CCM) services has turned patients off — as multiple practices told CMS during a Feb. 21 webinar — then you should stick to a script and explore secondary insurance coverage.

Fine tune your patient messaging to boost CCM rolls

03/20/2017

by: Richard Scott

Stick to direct and open conversations with your patients when discussing chronic care management (CCM) services and you may boost your patient buy-in. The following example, provided courtesy of consultancy West Corporation, gives you a head start with your CCM discussions.

5 steps to make sure insurance coverage, staff are prepared for disaster

03/20/2017

by: Roy Edroso

Question: I read about a doctor’s office that was destroyed in a fire, and it occurred to me that we don’t have a protocol for emergencies. What’s a good checklist?

Despite lack of guidance, X modifiers not denied much more than 59

03/20/2017

by: Roy Edroso

If you haven’t been using X modifiers because you’re afraid it will increase denials, you may be surprised by their actual denial rates.

Concierge medicine model continues to grow

03/17/2017

Concierge medicine is still a niche industry, but in an era of decreasing reimbursements and increasing government regulation, it has become a more attractive option for some physicians running a small practice. The concierge business model, which operates under several names including “direct pay,” has been around for 20 years and once catered to wealthy clients in affluent urban and suburban areas. But changes in the way small practices operate—and the proliferation of high-deductible health plans—is prompting physicians and consumers to give the model a second look.

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