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?

Medical Financial Management

I was asked to co-present for a Medical Group Management Association (MGMA) certification course on the topic of Financial Management in Healthcare. The session used to be two days, apparently had been reduced to one. Explaining financial concepts is a pretty dry subject – condensing it into a time slot required for the webinar takes [...]

By |2020-04-28T12:42:09-05:00May 28th, 2018|Finance, Healthcare, Management, Medical|Comments Off on Medical Financial Management

Prior Authorizations, Denials, Death?

Are you aware how much time your practice spends obtaining prior authorizations for a patient’s care? Are you aware of the clinical knowledge one must know or have documentation for in order to obtain a prior authorization? I have a client that told me he had a nurse consistently sitting on hold with a particular [...]

By |2020-04-28T12:42:09-05:00August 13th, 2017|Finance, Healthcare, Medical|Comments Off on Prior Authorizations, Denials, Death?