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?

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

Poignant Prosperity of Planning

Like most professionals in my lifetime I have participated in or led many small-scale and a few large-scale projects. Why does every organization have “project teams” or strategic projects going on? The answer is simple, for an organization strategic growth and continuous improvement is what keeps an organization healthy. Technology ages by the day, your [...]

By |2020-04-28T12:42:10-05:00May 14th, 2017|Business, Healthcare, Small Business|Comments Off on Poignant Prosperity of Planning

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

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

Fair Pay – in Medicine

What is the first thing that comes to mind when you think about fair pay? Minimum wage? The pay gap between men and women? What about a profession that is reimbursed derived from political processes trying to keep costs under control? A profession that requires at least eight years before using your skills? Education costs soaring [...]

By |2020-04-28T12:42:11-05:00February 12th, 2017|Business, Finance, Governments, Healthcare|Comments Off on Fair Pay – in Medicine

Personal Side of Broken Health Care

One thing all citizens of our divided country can agree on is the state of our healthcare system is broken. As a patient and a "consumer" of health care services, my out of pocket expense has increased consistently over the last decade at a pace far exceeding the cost of living index. I am making [...]

By |2020-04-28T12:42:11-05:00January 27th, 2017|Healthcare, Small Business|Comments Off on Personal Side of Broken Health Care

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

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

Prepare

I have heard a lot of people around me say they are “preparing” or getting ready for the season. Whether it is the weather or a religious season preparation seems to be in the air. Thanksgiving is finished and the turkeys and fixings were all prepared and devoured, time to prepare for the last calendar [...]

By |2020-04-28T12:42:11-05:00November 27th, 2016|Business, Finance, Healthcare|Comments Off on Prepare