With all the useful information available on Physicians Practice, it is easy to become overwhelmed. With this in mind, the tip of the week is a chance to reflect on some of the wisdom found all across the site. In a February 2021 story on  five telephone etiquette tips for medical practice staff ,  Carol Stryker  writes the following: “Patient frustration and anger are generally the result of unmet expectations. It follows, therefore, that the fundamental task in improving patients' satisfaction is to manage and then meet their expectations. How your practice handles telephonic communication with patients provides four excellent examples. Offer to take a message if you are not immediately prepared to deal with the caller Ask if the patient can hold and wait for his answer, before putting him on hold. Don’t let the phone ring a half dozen times. When taking a message, tell the caller when there will be a response. Communicate and act as a team.”

  Billing is one of the most critical parts of running a behavioral health practice. This is especially true for large practices, as maximizing efficiency at scale significantly affects their revenue cycle. It’s important to set realistic expectations about the mental health billing process, which isn’t easy to integrate into regular workflows. To take on practice billing, clinicians must devote time to learning and accommodating new processes. This includes creating clean claims and monitoring them after submission, correcting and resubmitting rejected claims, negotiating denials, collecting payments from patients, and reconciling bank statements. If any of these steps are skipped, clinicians risk losing some of the reimbursement that is due. Expecting too much too quickly can lead to disappointment and possibly burnout, neither of which are conducive to competent practice management. Behavioral healthcare billing can be challenging at first, but plenty of clinicians and practices hav

  3 Revenue management KPIs people don’t talk about November 15, 2022 Jonathan Friedman, MBA These non-traditional KPIs have a significant impact on collections and cashflow. In 30 years of running revenue management the usual suspects come up in a Key Performance Indicator (KPI) Dashboard such as Charges, Payments, Adjustments, Net Collection, Gross Collection, Days in AR, AR over 90 Days and Bad Debt. Then you have the breakouts for each category by payer, CPT Code, Location, or ICD Code. There are 3 other KPIs that I track that may not be traditional KPIs, but they have a significant impact on collections and cash flow. Denials You probably notice the C codes related to denials such as CO 11 – Diagnosis Inconsistent with Procedure, CO 22 – Coordination of Benefits, CO 167 – Diagnosis is Not Covered, etc. I take the time to program a listing of denial codes that make sense to the practice. The C Codes are very generic and can only go so far to alert you of denial patterns and potenti

  Q:   Are there any changes to the telehealth billing in 2023? A:  For CY 2023, Medicare is finalizing a number of policies related to services, including making several services that are temporarily available as telehealth services for the Public Health Emergency (PHE) available at least through CY 2023. This allows additional time for the collection of data to help in determining whether or not Medicare will include service(s) as permanent additions to the Medicare Telehealth Services List. Centers for Medicare and Medicaid Services (CMS) has finalized their proposal to extend the duration of time that services are temporarily included on the telehealth services list during the PHE for at least a period of 151 days following the end of the PHE. This confirms CMS' intention to implement the telehealth provisions to ensure a smooth transition after the end of the PHE. These policies, such as allowing telehealth services to be furnished in any geographic area and in any originating

  Amid all the rules stemming from the No Surprises Act, a looming mandate for providers to send cost estimates to health plans looks like the biggest stress inducer. Various regulations under the No Surprises Act have created strain for healthcare finance professionals since the initial rules were published in mid-2021, but one pending requirement is the consensus choice as the heaviest lift. The obligation to provide an advanced explanation of benefits (AEoB) to insured patients will necessitate a level of interoperability between providers and health plans that doesn’t exist. How to make it happen is a vexing question for industry stakeholders. It's uncertain “how anybody’s going to do that, because nobody has the tools yet to make it successful," said Sandy Lood, vice president of revenue cycle with Cottage Health in Santa Barbara, California. The U.S. Departments of Health and Human Services, Labor and Treasury, which together oversee implementation of the No Surprises Ac

There are many reasons why you should outsource instead of trying to perform your medical billing in house with employees.  One big reason, is fraud protection.  Your hourly employees are only invested in their paycheck.  If they can't figure something out, they have no incentive to find the answer since they don't gain anything by taking the time to get a single, complicated claim paid.  And, they don't care enough to check for fraud risk.  LEVEL Medical Billing is motivated to work EVERY claim; and one of the screens LEVEL has is against fraud.  If we see a claim that has abnormal or potentially fraudulent data, we notify you to make sure there's not a discrepancy.  This saves you time and money against RAC audits, medical record reviews, and legal fees.

  For 90-minute new patient E/M visits and 45-minute return patient E/M visits, annual physician reimbursement was $409,894 under time-based billing and $188,065 under medical decision-making-based billing. Time-based billing was associated with higher physician reimbursement for longer evaluation and management (E/M) visits, while billing based on medical decision-making (MDM) led to higher reimbursement for shorter visits, according to a  study  published in  JAMA Network Open. Under a fee-for-service model, physicians are reimbursed for E/M services based on the number and complexity of problems addressed during a patient’s visit, known as the medical decision-making method. However, physicians may spend time on tasks that are not reportable under  MDM-based billing , such as medical record review, coordination of care, and documentation. This can lead to one to two hours of unreimbursed work for physicians. Time-based billing is an alternative method that reimburses physicians base