How to Choose a Best Medical Billing company
- 1. AAPC certified Coders
- 2. Is this your EHR? How does it work? (Run if your medical biller asks this question)
- 3. Federal government compliance
- 4. Technology- IT matters
- 5. It all boils down to money
- 6. Stuck in the bronze age when it comes to managing AR?
- 7. Still handling denials the old way?
- 8. Patient experiences – The bottom line that matters
- 9. Expand your horizons (with the right billing company by your side)
- 10. Provider enrollment is no longer just an administrative task
- 11. Stronger contracts = more revenue
- 12. Transition support – The need of the hour
- 13. LRRA (Lost Revenue Recovery Audit) – Ask for one
- 14. State Laws- Comply or die trying
- 15. Specialty-specific billing expertise is no longer a matter of choice
- 16. Do they understand your payers?
1.AAPC certified Coders:
According to Kareo, one of the front-runners in the EHR industry;
The greater demands of ICD-10, Claims scrutinizations from payers like never before,
and value-based reimbursement continues to take center stage; your medical
billing company must have certified and trained medical coders.
How Short-time increase your ogbyn Revenue
Here are top 6 factors that stop ob-gyn practices from realizing their full revenue potential.
Note: These are not 6 points hastily pilfered from the net but are based on our experience of working closely with ob-gyn practices over the years.
- Inconsistent revenue audits
- Coding issues that go unnoticed
- Inadequate knowledge of timely filing limits
- Improper billing for antepartum care and NST services
- Patient billing mistakes
- Small things matter
Okay, we can hear you saying “we know this”. But there is something you don’t know. It is that through simple steps and consistent efforts you can make course corrections. No need for expensive software upgrades, hiring an army of billing experts or major workflow changes. We recently helped an ob-gyn center based in New Jersey increase revenue by 60%. Get More revenue
Obstetrician Gynecologists Generated 10% More Revenue
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Know How BillingParadise increased 60% revenue for an OB/GYN Center - Case Study
By building capabilities and creating a data-driven culture an ob-gyn group improves outcomes and quality of care
Though BillingParadise helps 20+ Ob-GYN practices to improve their revenue, each ob-gyn center’s need is completely different. Most ob-gyn centers switch because they were not happy with third Party RCM provider, some look for an OBGYN specific billing company that offers end-end services at low cost, few want to outsource from a small in-house billing team to a full-fledged company. Very few practices are particular about coding audits, revenue cycle reports, following industry benchmarks, effective denial handling, and RCM enhancement through seamless EHR integration. Read More
Top 5 KPIs Healthcare CFOs Need To Measure
1. Days Cash On Hand2. Operating margin or operating profit margin percentage3. Net days in Accounts Receivable4. Cash Collection as a percentage of net patient services revenue5. Claims denial rate
Help the CFO Keep Track of the Healthcare Organizations Performance Blogs
10 Proven Strategies For Hospital CFOs To Increase Revenue Cycle And Operational Efficiency
Hospital CFOs Struggle to Keep Up With the Time
Here’s what 2016 taught healthcare CFOs and revenue cycle directors about RCM and compliance auditing
6 tactics to succeed
Healthcare CFOs: Evolving roles and responsibilities
ACO’s – A Step Towards A Healthy World!!!
Medicare, The White Elephant We Cannot Get Rid Of
INFOGRAPHICS: Deloitte 2013 Survey Throws Light on Physician Beliefs
BillingParadise offers free webinars conducted by subject matter experts that answer the biggest questions of healthcare professionals. Declining reimbursement and financial pressures have made it mission critical for orthopedic surgery centers to strengthen their contracts. Smart contract negotiation is essential to survive in 2018.
In this free webinar credentialing and provider enrolment expert, Michelle Graham will offer insights and need-to-know information on payer contract management. Learn how you can strengthen contracts and negotiate better fee schedules in this interactive webinar.
When will the webinar be conducted?
The webinar will be live streamed on 10th January 2018 at 11 AM EST
How?
It’ll be live-streamed through Facebook Live at 11 AM EST
Webinar on Risk Adjustment and RADV Audits
A sneak peak of what’s in the presentation:
Information on CMS’s Hierarchical Condition Categories
HCC payment methodologies
Documentation best practices
Top 10 RADV red flags
RADV medical record checklist
Practice reminders
Top 10 documentation issues
All-you-need-to know information on Risk Adjustment and RADV Audits
• This presentation contains information on RADV Audits, which pertain to Risk Adjustment and how Providers and Coding Professionals, must understand, that they too, can be on the hook in the event a Medicare Advantage Plan is audited and found to have deficiencies.
• CMS performs Risk Adjustment Data Validation (RADV) audits by reviewing provider medical record documentation to validate submitted diagnoses codes, as they correlate to HCC codes. Risk Adjustment Factor Scoring or (RAF), when properly reported, allows CMS to provide additional reimbursement to Medicare Advantage Plans, based on a Members’ overall health. The RAF scores are derived from the submitted diagnoses from what should be in the medical record. Higher weighted RAFs, correlate to sicker patients, which means a higher cost to the MA Plan to treat these sicker patients, hence, requires higher reimbursement to the MA Plans.
•
The main avenue in which Risk
Adjustment Fraud and Abuse occurs, is by reporting chronic conditions and
subsequent treatment, on patients that did not have the reported conditions or
care, or upcoding on existing conditions, to make it seem more severe in nature
than it is.
HCC coding tips for physician practice
It’s Third Quarter of 2017 and the Medicare Advantage (MA), Plans are ramped up and ready to begin a third set of “HCC Sweeps”, for the year. The beginning of each “sweep” period, by United, Humana, Freedom, Aetna and all the other players in the pond, should start with ensuring they have Certified Remote HCC (CRC – Certified Risk Adjustment Coders), coders in-house or remotely employed and this year, leave the novices at Risk Adjustment Coding, to train for the following year, instead of onboarding them now. In light of recent DOJ developments.
The recent allegations by the Department of Justice (DOJ) are significant, the DOJ has made has alleged, based on audit results, that some MA Plans have been involved with upcoding of diagnoses codes that exaggerated the severity of illness of some members. This led to much higher weighted HCCs and in turn more money from CMS to the plan, for that member annually. Please click on the following links for further information: https://goo.gl/b1ncUA
12 organizations providing MACRA Support for small practices
Hardly a week goes by in the healthcare industry without a major regulation hitting the headlines. MACRA is the latest healthcare reform that is forcing medical practices to rethink their clinical and financial strategies. Healthcare providers are desperately looking for MACRA support. We list out 12 trusted MACRA support providers who offer MACRA assistance for small medical practices and EPs. Equip your medical practice to face the challenges and seize the opportunities MACRA provides by making an informed choice.
10 reasons 2017 is going to be the year of AR management automation
2017 is the year of big changes. The healthcare industry is waking up to the benefits of blockchain technology, interoperable systems and value based payments. And most importantly of automating operational and financial processes to cut back on costs and increase efficiency.
Still stuck with outdated processes?According to a survey by Practice Profitability Index, declining reimbursement (60%) and rising costs (50%) top the major concerns of healthcare providers. Complex and time-consuming processes aggravate the downward pressures faced by medical practices. Smart practices are automating key revenue cycle functions such as AR processes to cut down on costs and manual efforts.
Read More: AR Automation Challenges
Here’s what 2016 taught healthcare CFOs about revenue management
Battling reimbursement challenges, shrinking margins and compliance hurdles hospitals are exploring options to cut back on costs and increase revenue. The decision to work with professional revenue cycle management companies can be tied back to the bottomline pressures healthcare organizations face. A survey by Black Book reflects this trend.
Read more: Healthcare Compliance risk Audit