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Insights to guide your practice. 

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How Physicians Can Successfully Negotiate Insurance Contracts

by Kaitlyn Houseman on January 10, 2017

Payer contracts represent a significant amount of physician revenue and should be evaluated with careful scrutiny. Physicians who fail to negotiate with payers or gain a clear understanding of insurance contracts risk presenting a financial blow to their medical practice.

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Topics: Credentialing

CMS Publishes Update on Electronic Clinical Quality Measure (eCQM) Value Sets for 2017 Performance Period

by Kaitlyn Houseman on January 9, 2017

The Centers for Medicare & Medicaid Services (CMS) and the National Library of Medicine (NLM) has published an addendum to the 2016 eCQM specifications (published in April 2016). This addendum updates relevant International Classification of Diseases (ICD)-10 Clinical Modification (CM) and Procedure Coding System (PCS) eCQM value sets for the 2017 performance year.

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Topics: CMS

New CMS Study Helps EPs Receive Full Credit in MIPS CPIA Category

by Jeff Jones, CPHP on January 5, 2017

Worried about participating in the Merit-based Incentive Payment System? CMS is conducting a Clinical Practice Improvement Activities (CPIA) Study that can help you meet the CPIA requirement. Individual clinicians and groups who are eligible for MIPS that participate successfully in the study will receive full credit for the Improvement Activities performance category. Applications for the study will be accepted from January 1 – 31, 2017.

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Topics: CMS, Merit Based Incentive Payment System, MACRA

4 Ways Small Practices Can Best Prepare for Value-Based Care

by Jeff Jones, CPHP on January 3, 2017

When it comes to government regulations and health care, change is inevitable. In contrast to the current fee-for-service care, the value-based care model aims to compensate physicians for high-quality service, clinical performance, and patient satisfaction. It's an exciting time for the future of healthcare, and small practices are uniquely situated to thrive in the transition to value-based care.

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Topics: Revenue Cycle Management, Value-Based Reimbursement, MACRA

10 Most Popular GroupOne Health Source Posts of 2016

by Kaitlyn Houseman on December 30, 2016

What a year it has been! Thank you to all of our readers for your continued support and readership. This year, our blog subscribers doubled and we celebrated 25 years of helping practices overcome some of the most difficult healthcare reimbursement challenges. We're looking forward to another great year and will continue to publish helpful content that helps your practice succeed in a rapidly changing healthcare reimbursement environment. But before we head into 2017, let's take a look back at some of our most popular posts from 2016.

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Topics: Revenue Cycle Management, Practice Management

How to Pick Your Pace for the Quality Payment Program

by Jeff Jones, CPHP on December 28, 2016

With 2017 upon us, many practices are scrambling to understand the Quality Payment Program final rule. The final rule was published on October 14, 2016 with CMS making significant revisions to the proposed rule. In the final rule, CMS increased the flexibility of the Medicare Access and CHIP Reauthorization Act (MACRA) by introducing an option-based implementation plan, titled “Pick Your Pace,” which allows providers to ease into MACRA for the 2017 reporting year.

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Topics: Merit Based Incentive Payment System, MACRA

2015 Performance Scores Released on Physician Compare Website

by Jeff Jones, CPHP on December 21, 2016

The Centers for Medicare and Medicaid Services (CMS) has recently released new quality data on the Physician Compare website, which includes 2015 Physician Quality Reporting System (PQRS) performance scores for group practices, individual physicians and other clinicians, and Accountable Care Organizations (ACOs), as well as non-PQRS Qualified Clinical Data Registry (QCDR) data for individual clinicians. Here's what this means to your practice.

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New Year, New Codes: 2017 CPT Code Changes Now Available

by Kaitlyn Houseman on December 20, 2016

2017 is just around the corner and with it comes a number of new CPT codes, deleted codes, and code revisions. The updates made enable providers to get paid for some work that is already being done while other updates remove barriers to providing certain services such as Chronic Care Management.

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Topics: Revenue Cycle Management, Coding

President Obama Signs 21st Century Cures Act into Law

by Kaitlyn Houseman on December 15, 2016

Earlier this week, President Barack Obama signed the 21st Century Cures Act into law. The Cures Act invests in President Obama's priorities in Science and Health by providing funding for various projects such as the Precision Medicine Initiative and Cancer Moonshot while targeting better EHR use and supporting health data interoperability.

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Topics: Interoperability, Incentive Programs, Healthcare Policy

Should Your Medical Practice Hire a HIPAA Compliance Officer?

by Jim Johnson on December 14, 2016

Although healthcare facilities of all sizes and types are required to choose a HIPAA compliance officer to make sure that regulations are followed, some choose to blend the role with an existing one. For small to medium-sized practices, the thought of hiring a full-time HIPAA compliance officer may seem financially unfeasible.

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Topics: HIPAA

What Doctors Should Consider When Weighing Independence vs Employment

by Keith Lage on December 13, 2016

A recent Medscape study found that self-employed physicians are more satisfied in their profession than employed physicians (63% vs 55%). However, the Employed Doctors Report 20161  states that twice as many doctors (27% vs. 13%) have switched from independent practice to employed. But why?

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Topics: Revenue Cycle Management, Medical Business, Physician Payment

Helpful Data Migration Tips When Replacing Your EHR

by Adrienne Schrimpf on December 8, 2016

Most EHR systems have fallen short of physician expectations over the years. System functionality, cost, and poor customer service have all contributed to a growing number of practices switching or replacing their EHR software. When practices are considering switching to a new EHR, data migration is a common question. Here I'll cover some helpful data migration tips to help your practice during the transition to a new EHR.

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Topics: EHR

Top 10 Most Common HIPAA Violations

by Jim Johnson on December 3, 2016

With HIPAA violation fines reaching up to $50,000 per occurrence and a maximum annual penalty of $1.5 million per violation, it's important for medical practices to ensure they are HIPAA compliant at all times. And while all possible HIPAA violations should be considered potential threats to your medical practice, some are more common than others. 

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Topics: HIPAA

Top 6 Challenges Facing Physicians in 2017

by Arun Murali on December 2, 2016

More than ever before, physicians are facing an abundant amount of challenges. Declining reimbursement, changing payment models, and uncertainties surrounding new administration and the Affordable Care Act just to name a few. While the coming year presents many challenges to physicians, we’ve identified six of the top challenges most common among physicians that can also be less intimidating through further education and, of course, much preparation.

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Topics: Revenue Cycle Management

4 Steps to Preventing Medical Claim Denials

by Kaitlyn Houseman on November 21, 2016

It's no secret that the relationship between health care providers and insurance companies is complicated. Healthcare providers are spending a significant amount of time and energy with patients just to find out that an insurance company will fight them on paying for the services provided. Preventing claim denials helps ease the complications but denial management doesn't come so easy to every medical practice.

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Topics: Revenue Cycle Management, Denial Management

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