iMAXX Medical Billing Solutions Knowledge Hub

iMAX Medical Billing Knowledge Hub

6 leverage points small practices have with payers


It’s commonly believed that small practices are at a disadvantage when it comes to renegotiating contracts with big payers. After all, these payers have the muscle to set the terms of the deal. But that’s not always the case. If you’re small, you may have more leverage than you think. Here are six things you may not have thought of that can increase your pull with payers. If you have them, make sure your payers know.   You keep long hours. For those practices that keep them, extended hours are a huge advantage, especially in primary care. “Having extended hours



How to get out of the office


“Time off? Surely you jest,” wrote C.K. Hebdon, MD, in response to Physicians Practice’s query about going on vacation. Hebdon is the owner and sole physician at the Center Performance & Longevity in Salt Lake City. An addiction medicine specialist, he says there is no other nearby specialist who can cover his clinic when he leaves, so he rarely takes time off from his practice. “And if I take a day off, I’m punished by having to fit in that day’s patient load into the surrounding days,” he notes. “Monthly visits and prescriptions must be maintained.” In Physicians Practice’s 2018 Great American Physician Survey, 29



The dangers of trusting your employees too much


Preventing and addressing dishonesty in the workplace continues to challenge my physician practice clients. Recently, a client suffered an extreme example of how workplace dishonesty can cause harm. Her scary story is unfortunately familiar to many providers out there. The situation began with a visit from a payer’s fraud department. The investigators reviewed patient charts with my client, the practice owner, and hinted at fraudulent billing and other improprieties. She could not understand the investigators’ claims and did not recognize the patient names at issue. She began by looking for the patients’ names in the system. We immediately realized the



6 back office billing strategies


The front desk staff is essential for checking in patients, collecting copays, and verifying insurance. But there’s more to the story, and out of sight doesn’t mean out of mind. Much of the heavy lifting for billing and collections is done in the back office, so it’s even more important to have a deep bench of talent, says Tammie Olson, manager and coding and compliance strategist at Management Resource Group. In this two-part series, Olson, who works at the Ocean Springs, Miss., firm, offers financial management and support services for the healthcare community. She shares six ways to get your



4 front office billing tips


If you want your billing and collections to be as smooth and effective as possible, you need to make sure everybody on your team is doing their part. Sometimes small tasks can fall through the cracks, and large ones can seem like more trouble than they’re worth. But when everyone on the team is focused on the goal, small tasks get done quickly and large ones seem easier. And when everyone is on top of their game, work runs more smoothly and your bottom-line will be healthier for it, says Tammie Olson, manager and coding and compliance strategiest at Management



In This Ohio Courthouse, Addiction Treatment Is Just Down The Hall


Originally published on February 12, 2019 11:17 am The Columbus, Ohio, area has been hit hard by the opioid epidemic. And local judges say their courtrooms are jammed with misdemeanor cases that are tied to addiction. Eager for solutions, they’re turning to a  treatment clinic in an unlikely location. On a busy morning at the Franklin County courthouse, Jessica Gurwin joins the crowd of people streaming through metal detectors and elbowing their way into elevators. “You have to be aggressive, you’ve got to cut in front of people a little bit,” she says with a laugh. On the sixth floor,



5 key ingredients for a successful startup


I work with many physician entrepreneurs with great ideas who want them to come to fruition. These physicians are often curious as to what would make their startup successful. You could argue that many ingredients go into a successful startup, and luck is undoubtedly one of them. However, there are additional elements that are necessary for success. Here are five critical elements that are sometimes missing when beginning a startup: No strategy Unfortunately, most startups—like many medical practices—do not have a strategy even though many claim they do. Rather, these physician entrepreneurs often have mission statements or goals. For example:



How to diagnose cash flow problems in your practice


Cash is the lifeblood of your practice. Recognizing how much money you have and where it is going is key to the survival of any business. It doesn’t matter if you’re running a multi-specialty clinic or a lemonade stand. The ability to predict and deal with cash shortfalls is critical to your practice’s longevity. Your understanding begins with three important financial reports. Three reports you should be looking at The income statement is the first report you will want to examine. This report shows the cash generated from your practice’s core business operations. Avoid focusing on the bottom-line figure, the net income.



6 strategies for better billing and collections


It’s that time of year again when everyone is planning ways to make the upcoming year their best year yet. If your practice is like most other practices, then one area where you could use some work is billing and collections. Here are six resolutions that can improve your billing and collections in the new year. Resolve to educate your patients. Insurance is complex and is getting more so. Physicians and their staff are now spending a lot of time on continuing education when it comes to billing. But patients could use a bit of schooling, too. Copays, deductibles, and



Ohio to rebid costly private Medicaid contracts


Dayton-based CareSource handles over half of state’s insurance plans. Gov. Mike DeWine wants to rebid the state’s contracts with private health insurance companies that manage billions of dollars of Medicaid benefits. About 1 in 4 Ohioans — 2.8 million people — are covered by Medicaid, which has a $28.2 billion budget for fiscal year 2019. The low-income insurance program is funded with a mix of state and federal dollars. But the majority of the money spent isn’t directly paid out for health care services. Instead, the money goes to private health insurance companies that are contracted to the state to