November 15, 2023
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated industry-wide standards for health care information on electronic billing and claims, while also protecting against health care fraud and abuse. It also addresses the protection and handling of health information of every patient. The point of HIPAA compliance is for every medical practice to implement an active...
October 31, 2023
Accounts receivable are legally considered assets of the business that holds them. They comprise the unpaid debt from fees for services and procedures performed – in our case, of a medical practice – and a bill has been sent or given to the payor for services rendered. So why are medical administrators always worrying about accounts receivable? Because when people don’t pay these bills in a time...
October 15, 2023
How can a fresh look at the customer service you’re providing your patients improve your practice’s bottom line? Studies show that happier patients can improve your receivables by nearly 50%. Happy patients are more likely to stay current with their bill, especially if offered payment plans and different methods of payment. By ensuring an efficient and pleasant patient experience at every...
September 15, 2023
As medical practices and courthouses digitize their records, they are having to shred or store their paper documents securely in order to avoid being in violation of HIPAA laws. Patients have always relied on their doctors to keep their health information safe and private – and they still do – but the battlefront has changed from simply locking a file drawer full of patients’ information...
August 15, 2023
When the Affordable Care Act (ACA), which is also commonly referred to as Obamacare, was passed, it was obvious that it was going to have a big impact on all facets of the health insurance industry. A few years have since passed, and this has proven to be true – even when it comes to medical...
July 31, 2023
Clean Claims are Key to a Healthy Revenue Cycle, one very important factor of an efficient medical practice billing process is the submission of clean claims to payers, both private and governmental. Working towards submitting claims that are free of errors the first time around will reduce claim denials and raise your reimbursement rate...
July 15, 2023
Summer time is always challenging for medical practices, your practice (as nice as it may be) can’t compete with the nearest beach or vacation hotspot. However, when it comes to back to school physicals and annual check-ups, it is your task as a medical provider...
June 30, 2023
As students are going back to school, many parents who work in the medical field may be wondering whether their children would pursue the medical field and if they would actually make good physicians when they grow up. Studies have shown that only 40 percent of physicians would even recommend the career path of...
May 15, 2023
The answer is probably both, the healthcare industry has been known to sometimes lag behind in adopting new technology. That is one reason why, in 2009, Congress passed the American Recovery and Reinvestment Act (ARRA). Part of ARRA authorized the Centers for Medicare and Medicaid Services (CMS) to disburse $27 billion to incentivize...
April 15, 2023
Medical billing errors are very common in the United States. Doctors begin a medical practice but usually have no business background, so they’re not accustomed to some of the technicalities that are imperative for you and your staff to understand in order to achieve the revenues you deserve...
March 31, 2023
Medical billing & collections can be a complicated and difficult process without proper organization. However, if the medical billing process is broken down into the following steps, it becomes a lot more easier to understand. 1. Registering patients – New patients must provide their personal information and insurance information...
February 28, 2023
Every company tends to outsource some of their business activities. Doing so can help to free up resources, which allows them to run their business more efficiently. However, deciding what to outsource can be quite challenging. Some activities may seem like they can be done just as easily in-house and for a smaller...
February 15, 2023
Many physicians are familiar with the drop in cash flow that occurs in the first few months of every year. During this time many patients have not yet met their deductibles and must pay 100% of their healthcare costs out of their own pockets. An average of $4,000 annual deductible for a family on a high deductible insurance...
January 30, 2023
There has been a fair amount of talk lately about value based care. As the healthcare industry shifts to this new model it will be up to healthcare providers, including physician owned medical practices, to find ways to engage their patients and provide...
January 15, 2023
Every medical practice is going to experience insurance claim denials. The trick is to keep the denial rate at an acceptably low level. Some practices work for years at a 10% denial rate without giving it much thought. 10% should not be seen as acceptable as it could add up to a significant dollar amount over the course of a year...
December 30, 2022
Benchmarking is the continuous process of analyzing an organization’s performance in key areas and comparing it against industry competitors’ performance for the purpose of measuring success. At times it may be difficult for a medical practice to determine its success. By using data collected by the Medical Group Management...
November 30, 2022
The bottom line is that successful billing in a medical practice is dependent on successful insurance eligibility verification. In all cases this should occur upon the patient’s first visit and before care has been provided. Ideally, the process is repeated on follow up visits to insure that the policy has not been modified or terminated...
November 15, 2022
We recently discussed how online reviews are used by potential patients and what their effect on a medical practice might be. In this article we will look at how to approach a negative online review of your medical practice, whether that review is in the form of a legitimate complaint or an angry rant. How you approach...
October 31, 2022
In the internet age many turn to the web for advice from user reviews for everything from what electronics to buy, what restaurants to eat at, where to vacation and more. When choosing a physician, it is no different. And why should it be? Choosing a doctor is arguably more important than the decisions...
October 15, 2022
A good and effective office manager is an essential part of a medical practice’s staff. As we’ve mentioned here before, not all physicians have the training or experience to handle the operation of their own business. In reality, most would prefer to focus on why they became doctors in the first place: patient care. An office manager...
September 30, 2022
Research conducted throughout the last ten years has pointed to an increasing level of burnout among medical students and doctors in residency. These students and residents are becoming burned out over the course of their training and experiencing physical and emotional exhaustion, a loss of empathy for patients,...
September 15, 2022
Having a small to medium medical practice necessitates training staff for highly specific positions. Often times what may be an entire department in a larger operation is handled by a single employee at a doctor’s office. This makes sense because in a smaller practice individual staff members will likely be expected to handle...
August 15, 2022
After spending some time listening to physicians and other health care providers, not to mention some harsh criticism from Congress, The Centers for Medicare & Medicaid Services (CMS) and The Office of the National Coordinator for Health Information Technology (ONC) released the Meaningful Use Final Rule last...
July 30, 2022
The complexities of setting up and running a medical practice may seem overwhelming. Understandably, most physicians do not have extensive experience running a business, but the prospect of working for oneself is still enticing. For this and other reasons, it is highly advisable to consider obtaining the services of a medical practice...
May 31, 2022
Most physician’s offices are started because a doctor or group of doctors want to do what they know and love: treat patients. Good medical practice management is not just about providing excellent care, however. Sound business practices are required for efficiency and success. Put those practices in place and there will be more time and...
May 15, 2022
We are all familiar with the Health Insurance Portability and Accountability Act (HIPAA) and the safeguards it requires to insure the privacy of health records. At the same time there is a strong demand from all involved, doctors, insurance companies and patients themselves, for easy access to those records. It is also important to consider...
April 30, 2022
Most physicians who open their own private practice do it out of a desire to provide service to their patients and to build on their relations with those patients. In short, to practice medicine. More often than not, the running of a business is secondary...
March 31, 2022
The medical insurance billing debate continues and many believe that the traditional mode of fee-for-service reimbursement, where individual services are billed and paid separately, may be on its way out. On the other end of the spectrum, capitation, where a lump sum is paid per patient, regardless of what services are performed...
February 28, 2022
Medical Practice Operations and Your Bottom Line - In these times when medical practices are seeing decreased and declining revenues, it is essential to review your practices operations and ensure that you have what we like to call “best practices” in place. A successful medical practice requires many important moving parts...
January 30, 2022
Running an efficient medical practice is very important to your ability to treat all of your patients in a timely fashion. Unfortunately, bottlenecks can occur during any day that can put you massively behind schedule. When this happens, you can end up dealing with a lot of annoyed patients who are waiting around well past their...
January 15, 2022
Submitting Incident to Billing Claims To many physicians and medical practice staff members incident to billing can be a somewhat confusing concept. When billed "incident to" for services provided by a non-physician practitioner (NPP), like a nurse practitioners, physician assistants or...
December 30, 2021
Having accounts receivables that are too high is generally not a good thing. It means that your practice may be too lax in collecting the money that’s owed to you. It can also end up hurting your business, especially if you begin to have difficulties finding the...
December 15, 2021
As medical premiums have increased, employers are have to select policies that have greater patient responsibility in efforts to keep premiums down. In light of the mentioned, Patient Collections is now more important than ever, since is not just small co-pay, but instead patients...
November 15, 2021
Does Your Revenue Cycle Need Maintenance? Many physicians are experiencing a conundrum. They are working longer hours but not making more money. It is a fact that medical practice expenses are on the rise, and insurance payments are...
October 31, 2021
Health and Human Services Secretary Xavier Becerra, announced that he has renewed the COVID-19 Public Health Emergency declaration. This renewal is effective October 18, 2021 and will extend current Public Health Emergency flexibility another 90 days from that date, to January 16, 2022...
October 15, 2021
To ensure that your medical practice is successful, you need to understand that you have the right to a full and fair appeal review and you need to hold payers accountable for decisions that impact patient care – and your revenue. However, writing a medical insurance appeal in order to dispute a rejected claim can be quite challenging...
September 30, 2021
Patients today expect more from their physician experience than ever before. Communication and transparency are of utmost importance to many patients, but the more fundamental aspects of the relationship should not be ignored. Patients visit physicians in varying states of vulnerability. They are looking for someone to...
September 15, 2021
One of the biggest issues facing the health industry today is the fact that the industry is continuing to rely on developing health services that are too complex instead of involving the patients. To most patients, improving healthcare doesn’t equal more services...
August 31, 2021
Consistent cash flow is essential to the health of any business. This holds true for medical practices, as well. Maintaining an adequate level of revenue while minimizing the number of claim denials can be a struggle. Unfortunately, claim disputes have a number of associated costs beyond the denied payment...
July 15, 2021
The healthcare insurance industry is in somewhat of a flux at the moment, which can cause problems for any practices that aren’t paying careful attention to what’s going on. For example, patients are being held more responsible for health insurance costs than insurance payers, which is evidenced by the rising...
June 15, 2021
When it comes to the differences between struggling medical practices and successful medical practices, it often comes down to billing and collections efficiency and not the actual quality of the medical services. Maximizing your collections and improving billing performance will help to bring in more revenue...
May 31, 2021
To have a financially healthy medical practice you need to keep an eye on a number of indicators and compare those to industry standards. Billing benchmarks are a great way to compare your practice’s financial performance with the standards for the industry. What follows are some best practices and practical tips that...
April 15, 2021
If you run a medical practice of some kind, then outsourcing your medical billing and collections services might be something that you will want to look into. There are many benefits to outsourcing your medical billing and collections services, one of the most convincing being the ability to make more money...
March 15, 2021
Physicians and their staff members want to be optimistic about each new patient that walks into their practice, but it is not realistic to expect every patient relationship to be a positive one. Some patients might bring a bad attitude and negative energy to your office...
February 15, 2021
We fondly remember the days, maybe not so long ago, when the revenue cycle was a much simpler system. You would collect the patient’s insurance information, treat them, submit the claim and get paid. But in these days of high-deductible health plans (HDHP’s) and ever increasing co-pays...
January 31, 2021
“We need to talk…” Difficult Workplace Conversations, we all wish things (and people) simply worked the way they are supposed to, but sometimes there are issues that arise and must be dealt with. Sometimes those issues involve uncomfortable topics that must be addressed directly with a co-worker or employee...
January 15, 2021
Smaller medical practices often believe their size is what makes it reasonable to keep their medical billing in-house. The fact is that with ever changing regulations, rising costs, and fewer and smaller reimbursements, small medical practices are more likely to feel...
December 30, 2020
If you want to identify whether your revenue cycle management system is performing well, then you’re going to need to track the data that is available through the system. However, there is a ton of different data that you could be measuring and monitoring. The following are a number of...
October 31, 2020
Sometimes, you may find yourself in a situation where you need assistance with your medical practice in terms of solving a particular business problem or figuring out a way to maximize your return on investments. However, you may not want to take on additional employees...
October 19, 2020
By learning more on the steps your healthcare business can take to streamline its operations in the coming months, you can find new avenues for business growth. Our team at ProMD Medical Billing has many years’ experience helping healthcare firms improve their...
August 31, 2020
As a medical professional, you may feel like you want to control every aspect of your practice. However, doing so may not always be possible since attempting to manage your practice on your own could stretch your resources...
July 31, 2020
When a patient calls your office to make an appointment, front desk staff should collect current, complete information or give patients the option to mail or email it instead...
July 15, 2020
Submitting claims to insurance payers can be a time-consuming task. Medical practices that are understaffed often take a while to submit their claims, which in turn reduces their revenue since this means that it will take a while to get paid...
May 15, 2020
The Centers for Medicare & Medicaid Services (CMS) is no different. Realizing its use of the social security number (SSN) as a member identifier could potentially put its more than 60 million enrollees at risk, CMS decided to update its patient identifiers to a more secure ID number to protect its customers and...
April 30, 2020
Medical coding allows insurance companies to determine whether certain procedures should be reimbursed, reduced or outright denied. As such, it's extremely important that medical practices don't make any errors in their medical coding. Accurate medical coding is necessary if you expect to obtain insurance reimbursement...
March 30, 2020
When it comes to running your practice, it’s extremely important that you have access to billings and collections software so that you can run reports. You should be checking your billing and collections reports regularly in order to keep track of the financial health...
February 28, 2020
It’s no secret that unpaid bills are a major problem for the medical industry. Collectively, more than forty billion dollars of medical bills are unpaid in the US alone, and estimates are that at least 20% of the public has unpaid medical services on their credit record. Getting paid is a big problem for many medical clinics!...
February 15, 2020
Medical billing outsourcing services are no longer a novel approach. Outsourcing is now as mainstream as you can get. It typically produces greater cost savings and outcomes following its streamlined processes, superior systems, state of the art technologies...
December 17, 2019
The medical billing landscape and rules are constantly changing. Billing assessments allow your practice to ensure that your billing processes and systems are current and appropriate. Assessing your current billing...
December 4, 2019
Handling your own billing can be a time-consuming and costly responsibility in terms of staffing, documentation, and record keeping. By hiring an experienced medical billing and collections team...
August 6, 2019
Medical billing outsourcing services are no longer a novel approach. Outsourcing is now as mainstream as you can get. It typically produces greater cost savings and outcomes following its streamlined processes, superior systems, state of the art technologies, economies of scale, and skilled labor laden with specialized knowledge and experience. In today’s complex and evolving healthcare marketplace...
July 7, 2019
Most industries grew more competitive and the same is true for the medical professionals, providers, organizations and institutions that comprise the healthcare industry. Similar to any other industry, health professionals such as physicians and surgeons are responsible not only for the health and well-being of their patients, but...
June 25, 2019
Many people talk about HIPAA compliance, but not everyone truly knows what it means. Sure, it means private medical information is to be kept private, but are people who work in medical offices absolutely certain how to stay in compliance with this rather serious legislation? There are two distinct HIPAA regulations that medical staff must be thoroughly versed in. Let’s talk about what they...
June 10, 2019
Doctors do not usually take any business classes during medical school – they are too busy learning how to save lives or how to heal people. Therefore, many doctors join a group practice, because it usually comes with its own management team to keep the practice on track. But for a solo practitioner who wants to hang out his own shingle, and not join a physician group practice, where do you...
May 29, 2019
So, what exactly is a billing and receivables audit? It’s an assessment, typically conducted by a third party, that examines the effectiveness and reliability of procedures used by a medical practice surrounding its billing and accounts receivables (money due the business). The audit is used to ensure the patient bills are submitted correctly, with the proper codes for insurance reimbursement...
ProMD Medical Billing has been providing expert medical billing services since 2004. Our medical billing company is composed of an array of revenue cycle management (RCM) professionals, including certified medical billers and coders with more than 20 years of professional medical billing service experience.
Feel free to call or email us at anytime.
We look forward to exceeding your expectations in everything we do.
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