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GroupOne Health Source Practice Management Blog

      

The GroupOne Health Source Blog

 Answers and Insights Every Healthcare Professional Needs.

 

Top Questions About Healthcare Revenue Cycle Management

by Kaitlyn Houseman on November 18, 2015

As with any business, healthcare providers must deal with the nuts and bolts of getting paid so that the business can continue to function and serve people. But in healthcare, revenue cycle management is complicated by a number of factors, including strict regulations, an ever-evolving payer mix, and consumers who are dealing with shouldering more of the cost of their care themselves.

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Topics: Revenue Cycle Management

The Importance of Preauthorization

by Ricki Ransom on November 16, 2015

In the medical billing world, preauthorization, prior authorization, precertification, and notification are terms that may be used interchangeably to mean that for certain situations and procedures, providers have to contact insurers in advance and obtain a certification number in order to be reimbursed properly (or at all) for services. Insurance verification and insurance authorization services play a vital role in revenue cycle management. In fact, most claim denials happen when a patient is ineligible for services billed by the provider.

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Topics: Revenue Cycle Management

15 Things to Know About the 2016 Medicare Physician Fee Schedule

by Kaitlyn Houseman on November 12, 2015

On Friday, the Obama administration issued its final rule for the 2016 Medicare Physician Fee Schedule that includes several health IT provisions.  The fee schedule – the first since repeal of the Sustainable Growth Rate (SGR) formula and enactment of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) – includes changes to payment policies, modifications to misvalued codes, and updates to quality performance metrics under the PQRS, the Medicare Shared Savings Program, and Physician Compare, among others. (Internal Medicine News, 10/31)
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Topics: Revenue Cycle Management, Medical Business, CMS, PQRS

What PQRS Payment Adjustments Could Mean for Your Practice

by Kaitlyn Houseman on November 10, 2015

Revenue cycle management in many medical practices will soon have to take into account the Physician Quality Reporting System (PQRS). PQRS uses payment adjustments to encourage promoting of quality information by both group practices and eligible professionals (EPs).

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Topics: PQRS, Incentive Programs

Bipartisan Budget Act of 2015 Signed Into Law

by Keith Lage on November 10, 2015

On Monday, November 2, President Obama signed into law the Bipartisan Budget Act of 2015. Among its provisions, the two-year budget deal sets 2016 Medicare Part B premium rates, changes Medicaid rebate policy, repeals the ACA auto-enrollment requirement, and provides for a new Medicare payment policy for new outpatient providers.

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Topics: Revenue Cycle Management, Medical Business, CMS, Incentive Programs

The Social Media Controversy with Doctors

by Kaitlyn Houseman on November 9, 2015

Ten years ago, it was easy for doctors to keep a professional distance between themselves and their patients. They could have an unlisted personal phone number, for starters, which would leave the office number as the only publicly available way to contact you. Nowadays, doctors are personally available online 24 hours a day - if they have a social media presence. Here's how physicians can adapt and manage their social media presence without hurting patient relationships or sacrificing their own privacy.

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Topics: Practice Management, Marketing

Revenue Cycle Management: Outsourcing on the Increase

by Kaitlyn Houseman on November 8, 2015

Revenue cycle management is not something that most medical professionals understand, but it is a concept that is very near and dear to the bottom line of each medical practice. These days, medical practice management is being split up into two segments: managing the daily operations of the office and managing the way the practice does business. These are two separate functions and they both require full-time attention, which is why RCM outsourcing is on the rise.

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Topics: Revenue Cycle Management

Can Billing Software Help Minimize Denials?

by Keith Lage on November 6, 2015

Medical providers make most of their revenue by successfully processing claims, and claims mistakes affect the bottom line. Fortunately, many claims are preventable and recoverable. Successfully preventing billing mistakes and appealing a denied or rejected claim often has to do with the quality of the medical billing software a practice uses. 

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Topics: Revenue Cycle Management, Denial Management

New Sherwin-Williams Paint Kills Infection-Causing Bacteria

by Kaitlyn Houseman on November 6, 2015

Future hospital patients may have walls to thank for saving their lives. The new Sherwin Williams 59-color Paint Shield line promises to kill nearly 100 percent of several types of infection-causing bacteria up to two hours after exposure, and lasts for four years. 

The product, dubbed Paint Shield, earned certification from the U.S. Environmental Protection Agency for killing more than 99.9% of bacteria such as Staph, E. coli, and MRSA, Steve Revnew, senior vice president of product innovation for Sherwin-Williams said in an interview.

(Photo: Sherwin-Williams)

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Topics: Practice Management

What You Need to Know to Avoid a 2% PQRS Penalty

by Ricki Ransom on November 4, 2015


Healthcare revenue cycle management will undergo changes in coming years as fee-for-service payment models give way to more value-based payment models. The 
Physician Quality Reporting System (PQRS) began in 2007 as an incentive-based reporting program for eligible healthcare providers to report quality data to the Centers for Medicare and Medicaid Services (CMS) through Medicare claims forms.

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Topics: PQRS, Incentive Programs

Protect Your Practice: Advice on Preventing a Data Breach

by Kaitlyn Houseman on November 2, 2015

Data breaches are on the rise and healthcare is not immune, says Michelle Caswell, JD, Senior Director of Legal and Compliance for Clearwater Compliance LLCHealthcare organizations hear about the vulnerability of protected health information, but don't do much more than hope that they won't be the next target.

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Topics: EHR, Practice Management, HIPAA

5 Spooky ICD-10 Codes as Costumes

by Kaitlyn Houseman on October 30, 2015

With Halloween just around the corner, you surely have seen the various blog posts with Halloween ICD-10 codes. Since ICD-10 go live was this year, we decided to take it to another level. We thought we'd pair a few spooky codes with a costume. On the off chance you still haven't decided what you'll dress up as this year, feel free to snatch up one from this list of the top 5 ICD-10 codes with costumes.

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Topics: Revenue Cycle Management, ICD-10

Is Your Practice Taking Advantage of These EHR Benefits?

by Nicole Laucks on October 28, 2015

EHR stands for electronic health record and is essentially the digital version of a patient's paper chart. An EHR is a real-time record that can be made available instantly and securely to those with authorization. EHRs contain patients' medical and treatment histories and more. They may also include diagnoses, treatment plans, immunization records, allergy information, radiology images, and test results.

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Topics: EHR

Why Your ICD-10 Implementation Failed

by Keith Lage on October 27, 2015

You might be wondering why hundreds of practices experienced a smooth transition to ICD-10 but your practice didn't. Was it really that easy? Did you miss something? The ICD-10 transition was the biggest change to healthcare in decades. Why is my practice the only one struggling? 

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Topics: ICD-10

Don't Fall Short with Flu Season this Year

by Kaitlyn Houseman on October 22, 2015

With children back in school and people spending more time indoors, it's only a matter of time before flu cases start showing up in your practice. Of course, your best coping mechanism is doing what you can to prevent flu transmission in the first place rather than having to go into reactive mode after an influx of cases. For most practices, this means developing a plan to get patients vaccinated, but you need to define your plans in greater detail.

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Topics: Practice Management

Top EHR Vendors Adopt Metrics To Gauge Interoperability Progress

by Kaitlyn Houseman on October 21, 2015

A dozen electronic health record vendors have agreed to adopt a set of metrics and engage in ongoing reporting to help gauge the U.S. health care system's progress toward achieving interoperability, Modern Healthcare reports (Conn, Modern Healthcare, 10/19). 

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Topics: eClinicalWorks, EHR, Interoperability

Engaging Patients with Access to Their Personal Health Record

by Nicole Laucks on October 20, 2015

Attitudes toward health records have changed among patients and care providers in recent years. Once shrouded in mystery, the personal medical record is becoming more open to patients through online portals that let them review, and in some cases add to the information contained in them. EHR systems have changed the way providers and patients communicate and manage healthcare outcomes.

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Topics: Patient Engagement

4 Major Insurance Payers Share Policies on Reimbursing ICD-10 Claims

by Toshya Griffin, CPC on October 19, 2015

While the Centers for Medicare and Medicaid Services announced a year's grace period this summer when it comes to claims coded with ICD-10, not all large commercial payers are following suit.

According to the CMS announcement, during the 12 months immediately following the October 1, 2015, date, “Medicare review contractors will not deny physician or other practitioner claims billed under the Part B physician fee schedule through either automated medical review or complex medical record review based solely on the specificity of the ICD-10 diagnosis code as long as the physician/practitioner used a valid code from the right family.”

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Topics: Revenue Cycle Management, ICD-10

Top 15 TED Talks for Doctors

by Kaitlyn Houseman on October 17, 2015

Have you ever felt discouraged or uninspired? Maybe you feel overwhelmed with the small amount of time you have to learn about new advances in science and technology. If you don't have much time these days to explore new ideas in the health care, science, and technology fields then you're in for a real treat.

We've rounded up 15 TED talks surrounding some of the most remarkable ideas behind the advances in science and how they're shaping health care. Each TED talk is under 30 minutes so you can favorite them and listen later using the TED app. They're great for some quick inspiration and learning during lunch, on your way home or even when trying to squeeze in some cardio at the gym.

Did we miss one that you've found inspiring? Let us know in the comments below.

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Topics: Medical Business, Practice Management

6 Ways to Work Well with Difficult Patients

by Kaitlyn Houseman on October 12, 2015

Unfortunately, every medical practice has some of "those" patients: ones who are rude, disrespectful, noncompliant, or who behave inappropriately. Difficult patient encounters are made of three elements: the situation, the patient, and the physician.

Situational components may include language barriers, the presence of multiple people in the exam room, or having to break bad news to a patient. Difficult patients may be angry, defensive, frightened, grieving, or manipulative. And though it can be hard to admit, physicians play a role in difficult patient encounters too, by behaving defensively or arrogantly, for example. Having a plan for coping with difficult patients is important. Following are 6 steps you can take to improve difficult patient encounters.

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Topics: Practice Management, Patient Engagement