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Resolve to Improve in These Key Practice Areas

It’s that time of year again. As 2018 is winding down, many of us are looking back over the preceding 12 months to reflect upon the ups and downs, the wisdom acquired and the lessons learned. If you run your own medical practice, such a review will likely lead you to identity what worked in your current approach and what didn’t, particularly when it comes to billing and claims reimbursements.

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Medicare ID Cards: Proactive vs Reactive

June 11, 2018 By DIANE DESANTIS I have given much thought as to how Physician practices can relieve the anticipated stress, work overload and revenue reduction that potentially will be caused by the change in patient Medicare ID numbers. Since I believe that the affected population may have some difficulty in providing the new numbers… Continue Reading →

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New Medicare Beneficiary ID Cards

April 25, 2018 By DIANE DESANTIS Centers for Medicare and Medicaid Services (CMS) has begun the process of issuing new beneficiary cards (MBI) and has started mailing April 2, 2018 and will continue to April, 2019. The new cards will be mailed by geographic areas in phases. This change will GREATLY IMPACT YOUR REVENUE if… Continue Reading →

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MassHealth Referrals

March 20, 2017 BY LEANNE WRIGHT Starting next week we need to make sure that MassHealth patients enrolled in managed care plans and have referrals are being billed with the PCP as the Referring MD provider. In the past as long as the referral number is attached, they’ve processed. Now we Also need to make… Continue Reading →

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Last Day for Informal Review Request

December 7, 2016 BY DIANE DESANTIS The 2015 Annual Quality and Resource Use Reports (PQRS) were released on September 26, 2016. The 2015 Annual PQRS show how physician groups and physician solo practitioners performed in 2015 on the quality and cost measures used to calculate the 2017 Value Modifier as well as their 2017 Value… Continue Reading →

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Physician Quality Reporting System

November 15, 2016 BY DIANE DESANTIS 15 Days Remaining to Submit an Informal Review for 2017 Physician Quality Reporting System Results In 2017, CMS will apply a downward payment adjustment to those who did not satisfactorily report PQRS in 2015 including: Individual eligible professionals (EPs) Comprehensive Primary Care (CPC) practice sites PQRS group practices Accountable… Continue Reading →

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Credentialing Blues

August 20, 2015 By DIANE DESANTIS After 35 years in the business of medical practice administration, I still do not understand why clinicians have so much difficulty understanding insurance carrier credentialing. Everyone in the world knows that the money from a medical service insurance claim comes from an insurance company. How does the insurance company… Continue Reading →

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