Category Archives: iMAX Medical Billing Insights

IF YOU FIND IT MORE DIFFICULT TO MANAGE THE ENTIRETY OF YOUR MEDICAL PRACTICE WHILE MAINTAINING THE COMPLEXITY AND EFFICIENCY OF YOUR REVENUE CYCLE MANAGEMENT, YOU SHOULD CONSIDER OUTSOURCING. Saves Time and Resources It takes a great deal of time to hire, train, and maintain a revenue cycle management (RCM) staff. With the ever-changing regulations and protocols in the healthcare industry, outsourcing relieves your business of these burdens and allows you to focus on the core of your medical practice. Enhances Revenue Generation An RCM service will be able to generate a higher practice income through efficiencies of scale, broader

Healthcare consumers are unhappy with current patient billing and collection processes and they are calling for more digital, convenient options, a new survey shows. Source: Getty Images  By Samantha McGrail October 18, 2019 –  Half of healthcare consumers are frustrated with their provider’s patient billing and collections processes, especially those that are not yet digital, a recent survey of over 1,000 individuals showed. The survey conducted by Survata on behalf of Cedar, a patient payment and engagement platform for providers, found that provider billing issues are often the reason why patients don’t pay medical bills.  Thirty-four percent of US healthcare consumers have had a healthcare bill

A new study found that physicians who accepted gifts from pharmaceutical companies for the promotion of opioid medications prescribed more of the drugs. Source: Getty Images  By Jacqueline LaPointe November 06, 2019 – Gifts from pharmaceutical companies that sold opioid medications led to more opioid prescriptions in the year following gift receipt, a new study from the University of Pittsburgh Graduate School of Public Health revealed. The study published in the Journal of Pittsburgh Graduate School of Public Health found that physicians who accepted gifts from the pharmaceutical companies were more likely to prescribe opioid medications to patients compared to physicians who did not receive

On average, physician practices spend nearly $1,000 a month on provider directory maintenance because of the number of health plan contracts they have, CAQH reports. Source: Getty Images  By Samantha McGrail November 19, 2019 – Nationally, provider directory maintenance cost physician practices about $2.76 billion each year, with each practice spending $998.84 on average every month, according to a recent survey conducted by the Council for Affordable Quality Healthcare (CAQH). “Our nations fragmented approach to maintaining provider directories is not only a burden on physician practices, it may be undermining the accuracy of the data,” said April Todd, CAQH Senior Vice President for CORE and Explorations.

Avery Hurt Practice Management, Employment, Overhead, Physician Productivity Money isn’t everything. When it comes to motivating employees, money may be not be nearly enough. Psychologists are increasingly discovering that money is not the best motivator. Sure, people have to make enough money to pay their bills. But when it comes to getting them to go the extra mile for the team, it takes more than a good paycheck. Fortunately, for practice managers, often the best motivators are relatively easy, inexpensive, and often a whole lot of fun. Try a few of these ideas at your practice, and see if your team is more

Doctors and practice administrators are always looking for how to maximize profits. As a coding/billing consultant, chart auditor, and educator, I’m often asked about ways to improve coding. Here are three codes that I find are often misunderstood, underused, or unknown. Practices that know about these codes—and how to use them—may be able to earn additional reimbursement. 99441-99443: Telephone services Doctors’ offices are busy places, and it isn’t unusual for patients to call in asking to speak with the doctor. CPT offers codes to report telephone services provided by a physician or other qualified health care professional who may report

Your bottom line is a function of the money you receive and the money you spend. This article is the first of a two-part series that focuses on one facet of how your payer mix impacts your revenue. Before we discuss the importance of payer mix, let’s review some revenue math. A dollar charged is not a dollar earned because the dollar just doesn’t go that far in a medical practice. You get the sum of the co-pay, the deductible and what the patient’s insurance pays, but that rarely equals the amount you charged. That’s part of revenue math, where

An overwhelming majority (92 percent) of patients want to know their payment responsibility prior to visit. This statistic, from InstaMed’s seventh Trends in Healthcare Payments Report, highlights the recent shift in patient financial engagement. Patients have become consumers who seek transparency and flexibility when paying for healthcare expenditures. However, medical groups are lagging when it comes to meeting consumer expectations of identifying, and collecting, out-of-pocket liability. Technology solutions are beginning to make accurate patient estimates a scalable solution to not only identify but help medical groups engage in best practices for collections. Patient cost identification should focus on more than running patient eligibility

Each new denial is essentially a revenue leak. Even when claims are recovered, the costs associated with that recovery must be subtracted from patient revenue. Recent data put that recovery cost at roughly $118 per denial. Factor in the lost revenue from your unrecovered claims and it’s clear why denials are a painful financial drain on practices.   What makes denials so frustrating is that many are avoidable. The leading causes are well known, and it’s possible to prevent these leaks before they occur. The key is having processes in place to identify and correct errors and omissions before a problematic claim is ever

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