Up-Coding, Under-Coding – Huh?

Up-Coding, Under-Coding, Right-Coding - Medical Billing Audits what does it all mean? All medical providers receive requests from Medicare or Medicaid entities to provide documentation to review the accuracy of the coding. These inquiries may result in paybacks or recoupment of funds and/or informational letters describing the nature of the findings. Large health care entities [...]

By |2020-04-28T12:42:09-05:00August 5th, 2018|Finance, Financial, Healthcare|Comments Off on Up-Coding, Under-Coding – Huh?

ACCOUNTING vs. BOOKKEEPING

I graduated from Luther College from a double major in Accounting and Management [SHOUT OUT to all the Luther Alum around the world!] I entered a fairly common trajectory for an accounting graduate at the time (all documented in my LinkedIn profile – take a look). I took a position with a public accounting firm, [...]

By |2020-04-28T12:42:09-05:00June 24th, 2018|Business, Finance, Financial, Healthcare, Medical, Small Business|Comments Off on ACCOUNTING vs. BOOKKEEPING

Benefits + Small Business = Big Business

As I enter the time of year to evaluate employee benefits and as the NEW owner of an existing business that currently doesn't offer health insurance, the expense will be most likely considerably more. I get this. I want the best employees, I want productive employees, and I want to show the world - MY [...]

By |2020-04-28T12:42:10-05:00July 30th, 2017|Business, Employment, Healthcare, Human Resources|Comments Off on Benefits + Small Business = Big Business

Provisions of the American Health Care Act – Part 1

Effect on Patients and Businesses The American Health Care Act rolls back individual requirements to carry health insurance. Two provisions of the AHCA would be retroactive to December 31, 2015 include: Individuals would not be penalized for being uninsured The Act would eliminate the employer mandate to provide coverage without a financial penalty Other provisions [...]

By |2017-03-18T20:08:51-05:00March 18th, 2017|Finance, Financial, Governments, Healthcare, Human Resources, Medical, Small Business, Taxes|Comments Off on Provisions of the American Health Care Act – Part 1

American Health Care Act 2017

The Republicans did it, they put out their “repeal” of the Affordable Care Act. Forty-nine days into the Trump administration the American Health Care Act was unveiled. I could launch into rhetoric about how flawed the bill is or how keeping key aspects of the ACA isn’t truly repealing it. Instead, I reflect on a [...]

By |2020-04-28T12:42:11-05:00March 11th, 2017|Finance, Healthcare, Small Business|Comments Off on American Health Care Act 2017

Auditing Adjustment Codes

What do adjustment codes do on the payers’ explanations of benefits? These codes tell the payee – the provider why all the money charged was not collected. Perhaps it is a contractual adjustment (difference between what was charged and what the contracted rate with the payer is). Perhaps there is patient liability. There might be [...]

By |2020-04-28T12:42:11-05:00February 26th, 2017|Business, Finance, Healthcare|Comments Off on Auditing Adjustment Codes

The Coding Commodity

The Merriam-Webster dictionary defines commodity as “something useful or valued.” In healthcare, coding is the most important yet silent commodity in the revenue cycle. With over 68,000 medical diagnosis codes available through ICD-10 and over 87,000 procedures codes for providers to comb through, coding specialists are essential to get paid. Though electronic health records were [...]

By |2020-04-28T12:42:11-05:00January 22nd, 2017|Business, Healthcare, Medical|Comments Off on The Coding Commodity

Are You Eligible?

Calls come in daily for new appointments. Some calls are existing patients and some are new patients. There may be patients waiting to check in. How fast can you get the patient an appointment and get them off the phone? Is this the correct way to measure customer service? Patients might become impatient with wait [...]

By |2017-01-07T16:17:39-06:00January 7th, 2017|Healthcare, Management, Small Business|Comments Off on Are You Eligible?

Emotional Contracting

Yawn. The most BORING topic – yet one of the most important for medical providers. With thirteen plus years in medical accounting/patient billing, I know this is a commonly overlooked detail. Do you know all the payers with whom you are contracted? Do you know all the payers who pay you? How often is this reviewed? [...]

By |2020-04-28T12:42:11-05:00January 2nd, 2017|Business, Finance, Healthcare|Comments Off on Emotional Contracting

Medical Payer Mix Mess

How many of us have been told by our financial planners we need to diversify our portfolios? As a business you need to do the same thing, except looking at who you are billing. Medical practices already have one of the most complex payment systems of any industry (except maybe the US Treasury for tax [...]

By |2020-04-28T12:42:11-05:00October 15th, 2016|Finance, Healthcare, Small Business|Comments Off on Medical Payer Mix Mess