Prevention is better than Cure – Same goes with the claims

Approximately 40% of all medical claims contain errors. With strict insurance guidelines for medical billing and coding and constant changes to billing rules, many of these claims are likely to get rejected. The cycle of submission, rejection, editing, and re-submission can take weeks, often resulting in providers waiting for months before receiving payment for their services. Not only is this significant administrative cost, but also an average of $25 is taken from the practice per claim for corrected claims, re-submissions, paper submissions, appeals & human efforts utilized for these rejected claims. Eventually, we do get paid for some of these claims however, this brings down the practice profitability to approximately 50%. Read more ›

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Sunset To Consultation Reimbursement

Technology is considered to be driving force behind improvements in the health care system. Health informatics agree that research and treatments allow medical providers to use new tools and find innovative ways to practice medicine into the future. One of the tangible ways the technology has changed healthcare is that it has increased the accessibility of treatment. Secondly, it has improved care and efficiency making patient care safer and more reliable in most applications. Lastly, the software has improved disease control which allows medical professionals and researchers to track, retrieve and utilize valuable data in the fight to control disease and provide better healthcare outcomes. Read more ›

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Getting the Most out of MIPS Part 2: How to achieve 100% Score in Advancing Care Information Performance Category

In part 1 of this series, we saw how to maximize your score in Quality Performance Category. In this blog, we’ll talk about Advancing care Information and tips for achieving 100% performance in this Category. Advancing Care Information (ACI) is one of the four performance categories for MIPS and accounts for 25% of the Composite MIPS Score. It replaces the Medicare EHR Meaningful use incentive program.

Advancing Care Information will be reweighted as 0 for Hospital based Clinicians, non-patient facing clinicians, NP, PA, CRNAs, and CNS. Clinicians can apply to have their ACI weighted to 0 and the 25% assigned to Quality performance category for the following reasons: Read more ›

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iPediatric EHR – A Flawless Platform to keep track of a Child’s Growth & Nutrition

iPediatric EHR is a perfect solution for the Pediatricians. A Pediatrician treats childhood illnesses including physical, behavior, and mental health issues. This software enables you to create and maintain a complete family profile. The Pediatricians have one click access to the charts and other useful features. This is the only EHR that is designed to meet the unique needs of pediatrics practices. iPediatric EHR comes with comprehensive templates and workflow for Annual Physical Exam, Well Child Visit, Sick Visit, Growth Charts approved by CDC and WHO consisting of information like weight, age, stature, BMI, Head Circumference, etc. Additionally it contains Special Growth Charts for Down’s syndrome and premature baby. Read more ›

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Getting the Most out of MIPS Part 1: Maximizing your Quality Performance Category Score

MIPS (Merit-based Incentive Payment) is one of the pathways under MACRA Quality Payment Program  which streamlines multiple quality reporting programs and provides payment adjustments to eligible clinicians based on their performance across four performance categories – Quality, Cost, Improvement Activities and Advancing Care Information. Cost Category is not being scored in 2017. In this 3 part series, we will explore the performance categories and how to optimize your score in each of the categories. Read more ›

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Watch out “Bundling”: Maximize profits through Revenue Cycle

It is not easy as it used to be to manage the financial aspect of any healthcare practices. The providers have to face complex challenges as day to day the Government is changing the rules and regulations. Anyone who is involved in the operational aspect of the medical office or healthcare facility understands that there are many situations that require making educated and rule-based decisions on various factors. Some of them being, use of the medical code bundling and the use of modifiers. Read more ›

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Looking for a better way to Bill? Paperless Billing and collection

There has been a steady rise in the HealthCare revenues from patient’s portion, from the past 7 years. With increasing copays and the rise of high – deductible plans, healthcare consumers have more out-of-pocket costs than ever before. Large and small medical group continue to struggle with collecting money from the patient they’ve owed. For the most medical group the pressure is to strike a balance between resolving patient balance and maintaining patient satisfaction to retain the patient. The smartest way to manage patient payments is to collect more, faster and at less cost with better patient experience. Read more ›

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New Medicare Cards may affect your Billing process!!

Most medical providers genuinely serve to improve their patients’ health. Fraud in healthcare system is identical to any other industry and some fraudsters take precedence to unjustly profit.  Healthcare crooks include patients, payers, employers, vendors, suppliers, and providers.  Orderly crime rings and computer hackers also play roles in committing health care fraud.  Due to this, Medicare has taken initiative to get rid of Social Security Numbers from Medicare CardsRead more ›

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MACRA Proposed Rule – Year 2 Key Takeaways

On 21st June 2017, Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would make changes in the second year of the Quality Payment Program as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). With the proposed rule, CMS aims to simplify the program, especially for small, independent, and rural practices, while ensuring fiscal sustainability and high-quality care within Medicare. Read more ›

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Telehealth and Remote Patient Monitoring using EHR – How digital technology transforming?

There is no doubt that telehealth could potentially increase access to healthcare, decrease travel and improve continuity. People often make mistakes by considering telehealth as a replacement of in-office visits. In other words, in-office visits are the best form of care, but using telehealth is a better alternative than patients not seeing a doctor, at all. Conversely, considering all positive side of telehealth, the biggest is the lack of standardized payment methods. However, healthcare providers are appreciating the outcome of ongoing technological progress by having fewer hospital re-admissions, patient conveniences, better care outcomes, and a more profitable practice. Also, Remote Patient Monitoring systems are an integral part of telehealth implementation. Read more ›

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