Keeping a Close Eye on Medicare Fraud

Medical practices face many dilemmas in today’s healthcare landscape–from decreased reimbursements to increased patient demands—while fighting extinction in the current competitive environment. Overlooking certain operational efficiencies can lead to revenue loss, but not keeping those binoculars focused on changes to Medicare regulations can also lead to compliance issues–and even fraud. Observe Common Medicare Fraud Red [...]

2018-11-12T15:52:27+00:00January 5th, 2015|HEALTHCARE|

Healthcare Data Breach: You Could Be Ripe for the Picking

Community Health Systems (CHS), the largest for-profit hospital company in the U.S., recently announced a massive patient data breach due to an unprecedented malicious software (a.k.a. malware) attack. Per CHS’s disclosures, the company experienced sophisticated malware attacks April and June of 2014 from a group that may have originated in China. The group obtained names, [...]

2018-11-12T15:52:44+00:00October 28th, 2014|HEALTHCARE|

Four Steps to Facilitate Medical Practice Strategic Planning

To win the big tournament, golfers must spend time practicing at the driving range and putting on the green. Additionally, given today's rapidly changing healthcare environment, physicians must also spend time working on, not just in, their practices. Medical practice strategic planning can be a challenge, but analyzing the practice’s current standing and deliberately forecasting for [...]

2018-11-12T15:52:48+00:00October 12th, 2014|HEALTHCARE|

Improve Patient Accounts Receivable and Keep Cash Flowing into Your Medical Practice

As healthcare reimbursements continue to decrease and the responsibility of healthcare costs shift to patients, medical practices must properly manage and improve patient accounts receivable to keep cash flowing. Many employers are moving away from traditional health insurance plans as employer insurance costs continue to rise. High deductible health plans (HDHP) offer lower premiums to [...]

2018-11-12T15:52:54+00:00September 19th, 2014|HEALTHCARE|

Five Steps to Lift Self Pay Patient Collections in Medical Practices

Self pay patients were once a small percentage of a medical practice’s patient mix. However, in today’s market, the number of self pay patients is rising due to increases in health plan costs and the number of high-deductible healthcare plans. Medical practices can elevate self pay patient collections by implementing the below five steps. 1. [...]

2018-11-12T15:53:14+00:00July 9th, 2014|HEALTHCARE|

How to Orchestrate a Medical Practice Buy-Sell Agreement that Minimizes Disputes

Many medical practices will see an influx of new patients in the wake of healthcare reform. Some practices may respond to this influx by adding more physicians to their staffs. Recruiting and retaining physicians requires the skill of a conductor to keep all areas of the practice playing in unison. Just as a musician needs [...]

2018-11-12T15:54:02+00:00March 18th, 2014|HEALTHCARE|

Build Medical Practice Productivity with Non-Physician Providers

Every healthcare practitioner should work at the top of his or her license. That’s why non-physician providers - or NPPs - are essential to medical practice productivity. NPPs include nurse practitioners, nurse midwives, physician assistants, and physical therapists. These providers possess a skill set along the clinical continuum between registered nurses and doctors. Create a [...]

2018-11-12T15:54:03+00:00March 15th, 2014|HEALTHCARE|

How to Hit the Medical Practice Profitability Bullseye

How can you create medical practice profitability? They can begin targeting sound financial management practices and patient growth strategies that improve overall practice efficiencies. Pinpoint Financial Management Create a budget by checking the previous 12-month financial statement and then setting revenue and expense goals. The budget should include physician compensation and every line item. Scrutinize every [...]

2018-11-12T15:54:09+00:00March 9th, 2014|HEALTHCARE|

Balancing Act of Medical Practice Consolidation

Medical practices must balance the impacts of healthcare reform, decreased reimbursements, ICD-10 implementation, and other issues to remain profitable. While some physicians have decided to leave the private practice circus and work at a hospital, others are considering merging with or acquiring medical practices. Combining practices can create a greater revenue-generating entity with potential cost-saving [...]

2018-11-12T15:54:23+00:00December 13th, 2013|HEALTHCARE|

Taking Action: Medical Practice Fee Schedule Annual Review

In the wake of healthcare reform and delayed or reduced reimbursements, many medical practices may feel like they have a starring role in a horror flick. One way they can ease this potentially scary new reality is by examining fee schedules on an annual basis and adjusting accordingly for maximum benefit. Act One: Determine Top [...]

2018-11-12T15:54:29+00:00December 8th, 2013|HEALTHCARE|

Time is Money: Tracking the Work Relative Value Unit to Increase Physician Productivity

The adage “time is money” is particularly relevant when establishing a system to track physician productivity. Unfortunately, most practices use an outdated method that measures units, charges, and collections. These metrics do not accurately measure physician productivity because they are sensitive to modifiers, charge increases, payer mix, and changing reimbursement amounts. As a result, physician productivity [...]

2018-11-12T15:55:06+00:00June 11th, 2013|HEALTHCARE|

Economic Credentialing in the Form of Accountable Care Organizations (ACOs)

When health maintenance organizations (HMOs) evolved into managed care organizations (MCOs) approximately two decades ago, there was a strong push for provider panels to accept only physicians who could practice cost-efficient medicine. These parameters meant choosing doctors who used minimal resources without compromising quality. This process, called “economic credentialing,” provoked vigorous debate and lawsuits. The disputes [...]

2018-11-12T15:55:07+00:00June 7th, 2013|HEALTHCARE|

Six Secrets of a Thriving Medical Practice

What are the secrets of running a top-performing physician practice? Luckily, that’s not classified information requiring a security clearance. Here are the six secrets to building a thriving medical practice. 1. Track Medical Practice Charges and Collections If a practice is expanding and fees are increasing, then charges should increase steadily over time. To evaluate charges [...]

2018-11-12T15:55:25+00:00March 19th, 2013|HEALTHCARE|

Growing Medical Practice Patient Collections

Successful gardeners know that growing flavorful vegetables requires high attention to detail. Attention to detail is also necessary for a healthcare facility to maximize its collection rates. Planting the Seeds for Payment at Time of Medical Practice Service Planting the seeds for payment at the time of service (TOS) requires proper staff training on: understanding [...]

2018-11-12T15:55:35+00:00December 17th, 2012|HEALTHCARE|

How to Conduct a Routine Check-Up on Your Medical Practice

Just as we exhibit symptoms when we are sick, medical practices exhibit symptoms when they are not doing well. How do medical practices keep themselves healthy? They should conduct regular systems check-ups on the following aspects of their day-to-day operations: 1. Cash Receipts  - Are all payments promptly collected and deposited into accounts? - What [...]

2018-11-12T15:55:42+00:00December 10th, 2012|HEALTHCARE|

Weighing the Pros and Cons of Private Medical Practice

In today’s rapidly changing healthcare environment, many physicians are considering setting up a private practice. The most beneficial practice type depends on each physician’s professional goals, career path, and willingness to be involved in management decisions. Below is a list of the pro and cons for private practice and hospital employment that doctors should evaluate [...]

2018-11-12T15:55:51+00:00August 15th, 2012|HEALTHCARE|

Is the Medical Practice Grass Greener Out of Network?

Many physicians see few advantages to remaining on an insurance company’s provider panel. Physicians are transitioning to out-of-network provider status primarily because of billing and payment difficulties. However, is the grass greener out of network? Medical Practice Risks to Being Out of Network Because out-of-network providers avoid contractual adjustments and in-network claims processing, they may [...]

2018-11-12T15:56:06+00:00April 11th, 2012|HEALTHCARE|

Manage Patient Accounts Receivable and Maintain Cash Flow

As healthcare reimbursements decrease and patients incur greater responsibility for healthcare costs, medical practices must properly manage patient accounts receivable to maintain their cash flows. Many employers are moving away from traditional health insurance plans as employer insurance costs continue to rise. High-deductible health plans (HDHP) offer lower premiums to employers in exchange for higher [...]

2019-03-14T10:12:57+00:00July 17th, 2011|HEALTHCARE|