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Why outsource your billing?

 

Outsourcing makes good business sense.

Successful medical practices manage their relationship by continual face to face interactions with a competent billing service offering customizable services.

Achievable benefits with outsourced billing:

  • Free up office space
  • Reduce incoming phone calls
  • Turn fixed expenses into variable
  • Know your marketplace
  • Access solid data analytics
  • Know your accounts receivables
  • Have a resource at payer offices
  • Be prepared for a payer audit

SEE DETAILS ...

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What Value-based Care Models Are Available?

Value-based care comes in a variety of types, generally differing by the risks assumed by providers and sharing of savings or losses.

Read more: What Value-based Care Models Are Available?

How Is Value-Based Care Different From Fee-For-Service Models?

In the traditional fee-for-service reimbursement model, healthcare providers are paid for the amount of services performed. 

Read more: How Is Value-Based Care Different From Fee-For-Service Models?

What Is Value-Based Care, What It Means for Providers

Value-based care has emerged as an alternative and potential replacement for fee-for-service reimbursement based on quality rather than quantity.

Read more: What Is Value-Based Care, What It Means for Providers

Value-Based Payments: 2020 goals

The Health Care Transformation Task Force inched closer to its goal of having 75 percent of business under value-based payment models by the end of 2020.

The shift away from fee-for-service to value-based payment has been a slow, but steady journey. 

Read more: Value-Based Payments: 2020 goals

Conducting An EHR Vendor Assessment

 

Steps to Conducting an EHR Vendor Assessment

  • Identify high-priority needs.
  • Identify the most needed EHR features.
  • Set specific, measurable, attainable, relevant and time bound EHR goals.
  • List key decisions of potential deal-breakers.
  • Decide where to store the EHR data: in-office, vendor server, or web-based. 
  • Narrow the field:
    • Solicit the EHR experience of colleagues.
    • Obtain EHR evaluaton tools and resources from medical societies.
    • Utilize online information about different vendors.
  • Further narrow the field using various metrics comparing vendors.
  • Conduct 2-5 face-to-face vendor demonstrations.
  • Compare core functionalities, look and feel, and practice management features.
  • Personally preview each EHR on site, and contact references. 
  • Prepare lessons learned questions by your practice before, during, and after implementation.

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Solo Medical Practices

 

The solo practice has been on the wane for most of the past three decades.

FULL ARTICLE

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Podiatry Revenue Modifier

 

Your patient is readmitted to the hospital with cellulitis at the incisional site during the postoperative global period after a transmetatarsal amputation.   

You follow the patient for multiple daily visits.  No surgery performed. 

The only allowable coding option available refers to an "unrelated evaluation and management (E/M) service by the same physician or other qualified health care professional during a postoperative period."

Any diagnosis associated to the amputation will not qualify, only an "unrelated" one will. 

ALLOW US TO SHOW YOU

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Choosing The Right EHR

 

Choosing the right Electronic Health Records (EHR) for your practice can be a daunting task.  

There is enough research documenting improved productivity levels and efficiency gained by EHR Software implementation. 

Large physician practices may have financial flexibility to implement an EHR with bells and whistles driving up the price point.

Small practices often lack this luxury.

Read more: Choosing The Right EHR

Selecting an EHR vendor

Specific critical technological features exist to assure the overall practice success when choosing the right EHR.

Read more: Selecting an EHR vendor

Diagnosis Codes and Service Date Relationship

 

Diagnosis codes must be reported based on the date of service (including, when applicable, the date of discharge) on the claim and not the date the claim is prepared or received.

Read more: Diagnosis Codes and Service Date Relationship

Modifier Codes Instructions

 

When desiring to indicate a distinct procedural service the physician may need to indicate a procedure or service was distinct or independent from other services performed on the same day.

This may represent a different session or patient encounter, different procedure or surgery, different site, or organ system, separate incision/excision, or separate injury (or area of injury in extensive injuries).

Read more: Modifier Codes Instructions

Ophthalmology Surgical Modifiers

 

Ophthalmology Surgical Modifiers

  • Extracapsular cataract removal with insertion of intraocular lens prosthesis
  • Extracapsular cataract removal with insertion of intraocular lens prosthesis
  • Right and Left done on same day Number of units 1
  • Multiple surgical procedures
  • Performed at same session, by same physician on same day

ALLOW GIS TO ASSIST YOU

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Coder/Biller Wages

 

Because demands for coders is high, wages continue to increase with the average salary in Illinois reaching $50, 394 as of September 28, 2018.

Here are  salary statistics for a medical coder and biller in Illinois:

  • Top Earned $60,919
  • Median Wage $54,880
  • Lowest Earned $43,711

Read more: Coder/Biller Wages

Surgical Modifiers #2

 

Surgical Modifiers

  • Bilateral
  • Multiple
  • Reduced
  • Discounted
  • Co Surgery
  • Team Surgery
  • Assistant Surgery
  • Bilateral Surgery
  • Performed on both sides of body at the same operative session to the same organ or structure

ALLOW GIS TO ASSIST YOU

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