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GroupOne Health Source Blog

GroupOne Revenue Cycle Blog 

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In-House vs. Outsourced Medical Billing Services Analysis - Surgery

by Kaitlyn Houseman on June 21, 2012

8 Points on Whether In-House Billing or Outsourcing Services Makes More Sense for ASCs

Industry experts discuss different situations when either outsourcing billing services or creating an in-house billing department makes more sense for surgery centers.

Outsource billing services

1. High volume centers. In some situations, it makes sense for high volume surgery centers to outsource billing services because you don't want to fall behind on collections. "If you are a high volume surgery center and you constantly have dirty claims and you aren't making headway on your accounts receivable, it's usually a direct effect of your staff," says Kelly Grier, vice president of business operations for ASD Management.

Michael Pankey, RN, administrator of Ambulatory Surgery Center of Spartanburg (S.C.), runs an outpatient surgery center where physicians have about 10,000 patient visits per year. "The larger a center gets, the more beneficial outsourcing becomes because the more people your vendor can put on your account," he says.

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Topics: Medical Business, Practice Management, Revenue Cycle Management

Medical Billing Changes Coming Soon

by Kaitlyn Houseman on June 9, 2012

Starting July 1, 2012, Medicare Fee For Service Will Reject 4010 Transactions: Are You Ready?

Effective July 1, 2012 only ASC X12 Version 5010 (Version 5010) or NCPDP Telecom D.0 (NCPDP D.0) formats will be accepted by Medicare Fee-For-Service (FFS). Providers that are still conducting one or more of the Version 4010 transactions electronically, such as submitting a claim or checking claim status, or rely on a software vendor, billing service or clearinghouse to do this on their behalf, are affected by this change. Now is the time to contact your software vendor, billing service or clearinghouse, when applicable, if you have not done so already to ensure you are ready. Transactions conducted by Medicare Administrative Contractor (MAC), fiscal intermediary (FI) or carrier telephone interactive voice response (IVR) systems, Direct Data Entry (DDE) and Internet Portals, for those contractors with Internet Portals, are not impacted.

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Topics: Medical Business, HIPAA, Revenue Cycle Management, CMS

The Most Profitable Free Medical App Available

by Kaitlyn Houseman on May 8, 2012

The free medical app that currently makes more money than any paid one

Last November Physicians Interactive, which offer the popular Skyscape series of medical apps, began consolidating its many wares into one “destination” app, called Skyscape Medical Resources. The app is free to download but this week it topped Apple’s list of “Top Grossing” apps in the medical category. It’s the only top 10 grossing app on the list that’s free to download.

While the Skyscape Medical Resources app freely offers medical resources focused on drug information, medical calculators, and clinical information for more than 850 medical topics, the app also leverages Apple’s in-app purchasing functionality to offer users more than 600 premium resources that span 35 specialties. All in-app purchases are done through Apple’s AppStore but the new features are populated within the consolidated Skyscape Resources app. The company went from having hundreds of smartphone apps to just a few. Eventually, the strategy is to progress to just one app with in-app purchases, except for a few one-off apps PI develops with medical events partners and pharmaceutical companies.

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Topics: Medical Business, Practice Management, Revenue Cycle Management

Complete Survey: Help End the Underpayment of Med Insurance Claims

by Kaitlyn Houseman on May 8, 2012

Are your claims underpaid by private payers?  Do you have any way of checking the accuracy? 

According to the 2011 AMA Health Insurer Report Card, 1 in 5 claims are processed incorrectly.  In addition to measuring overall claims processing accuracy, the report card examined how accurately insurers reported the correct contract fees to physicians. Contracted fees were correctly reported 62.08% on low side (Anthem BCBS) to 98.91% on high side (Medicare).  For more information, read this.   

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Topics: CMS, Medical Business, Practice Management, Revenue Cycle Management

Pay For Performance/Value Based Purchasing Initiative Heats Up

by Kaitlyn Houseman on May 7, 2012

Thousands of physicians received a sneak-peek at their future recently when CMS sent them quality reporting data that could be used to determine Medicare payments. 

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Topics: EHR, CMS, Medical Business, Revenue Cycle Management

Top 5 ICD-10 pitfalls

by Kaitlyn Houseman on December 12, 2011

A panel of ICD-10 experts spoke last week at a conference co-hosted by the New England Health Information and Management Systems Society and Maine Healthcare Financial Management Association in South Portland, Maine, giving advice about the five ‘gotchas’ that can wreak havoc on the best-laid plans for implementing the new coding system.
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Topics: EHR, ICD-10, EHR Training, Revenue Cycle Management

Cuts in Medicaid Pay to Physicians by State

by Kaitlyn Houseman on November 11, 2011

According to a report released by the Kaiser Commission on Medicaid and the Uninsured, almost every state is cutting costs related to Medicaid.  Many states are implementing cost-cutting initiatives, such as restricting Medicaid benefits, implementing new and higher copayments for beneficiaries, and/or enacting provider rate restrictions. In fact, since July 1, 2010, 22 states have already slashed physician pay rates.

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Topics: EHR, Revenue Cycle Management, CMS

eClinicalWorks Video Demonstration - PM and Billing Tips

by Kaitlyn Houseman on September 19, 2011

In depth demo of eClinicalWorks’s practice management features with EHR billing tips.

GroupOne's eClinicalWorks revenue cycle management experience has helped thousands of physicians with claim management and revenue cycle management. With an end-to-end solution customized for eClinicalWorks users, we help our customers overcome eCW RCM challenges such as declining reimbursement, low cash flow, and lack of EHR optimization. 

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Topics: Revenue Cycle Management, eClinicalWorks, GroupOne, EHR, Practice Management, Denial Management

Burn Due to Water Skis on Fire? - There's an ICD-10 Code For That

by Keith Lage on September 19, 2011

Walked Into a Lamppost? Hurt While Crocheting? Burn Due to Water Skis on Fire? – There’s a Code for that. This is an article from the Wall Street Journal that was posted on Sept 13, 2011 regarding ICD-10. Some may find this interesting/amusing. ICD-10 is a good reason for medical practice to partner with a professional billing service firm like GroupOne Health Source.

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Topics: Revenue Cycle Management, ICD-10, Coding

4 Tips for a Strong Post-Recession Medical Practice

by Kaitlyn Houseman on August 22, 2011

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Topics: EHR, eClinicalWorks, Denial Management, Revenue Cycle Management

Maui Memorial Renews GroupOne’s eCW OneRate Medical Services Package

by Kaitlyn Houseman on August 10, 2011

    As part of physician integration strategy, one of the largest hospitals in Hawaii extends partnership with medical billing and EMR specialist to implement electronic health records software and billing services combination package.

Jefferson City, MO - August 10, 2011 – GroupOne Health Source, a medical consulting and billing firm, and Maui Memorial Medical Center (MMMC) agreed to renew and extend GroupOne’s OneRate platform of medical services for its growing group of affiliated health providers.  Located in Wailuku, the hospital originally opened in 1884 and is currently the largest facility run by the Hawaii Health Systems Corporation and the only acute care hospital on Maui.

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Topics: eClinicalWorks, EHR, EHR Training, Revenue Cycle Management, Incentive Programs

Medical Practice Doubles Revenue with GroupOne

by Kaitlyn Houseman on June 29, 2011

    Within three months, GroupOne’s eClinicalWorks Billing Center more than doubles community health practice’s collections. 

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Topics: eClinicalWorks, EHR, Revenue Cycle Management

GroupOne's 2010 Medical Net Collection Rate Exceeds 99.9%

by Kaitlyn Houseman on June 27, 2011

For medical practices that were with GroupOne for all of 2010, GroupOne’s overall net collection rate for 2010 exceeded 99.9%.  Based on industry survey reports, the average net collection rate for all medical practices is slightly better than 96.3%.  The rate for the better performing medical groups according to industry criteria is slightly more than 99.7%.    

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Topics: EHR, Revenue Cycle Management

The Effects of the ICD-10 Transition on Provider Practices

by Kaitlyn Houseman on June 27, 2011

Posted by Dana Deardorff 

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Topics: EHR, Revenue Cycle Management, CMS, Incentive Programs

AMA: Inaccuracy in Medical Claims Payment Increases to 20%

by Kaitlyn Houseman on June 23, 2011

How Do These Errors Affect Your Revenue?

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Topics: EHR, Revenue Cycle Management

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