Author: Michael Sculley

The Affordable Care Act is adding new patients to already over taxed health primary care doctors, creating even longer waiting times. Newly insured patients are trying to fully understand their benefits and their financial requirements. However, health industry analysts are also seeing an increase in concierge care, a service most people associate with the wealthy.

October 1, 2014 is when doctor’s offices have to begin using the new diagnosis codes, known as ICD-10 for filing claims with Medicare, Medicaid, all private insurance, and workers compensation. While the purpose of the change is to allow medical providers to bill with more detail such as left versus right side. The consensus is

Federal regulations require electronic medical record adoption in offices of all sizes, which means handwritten doctor’s orders and notes aren’t enough to back payment claims or keep facilities compliant with new rules. There are numerous efficiency benefits gained from EHR, but physicians entering their own orders and notes isn’t one of them. EHR documentation done

Professionals expect the market for healthcare revenue cycle management products to boom, driven in part by changes associated with measures such as the Affordable Care Act. Before things can take off, providers and vendors must work together to address the entanglement of problems that exists in the current RCM structure. Legacy Revenue Cycle Issues Healthcare

Fraud is nothing new, but that doesn’t mean it never changes. Certain parts of the ICD-10 implementation create obstacles for fraud detection. These are a handful of healthcare schemes to be aware 1. EHR-related fraud. As EHR systems become more prevalent, there are increasing issues with fraud related to auto-population. Trussell notes that some systems

If it seems like it’s harder to turn a profit on your medical billing services every year, there are a few reasons for that. Here are 6 operational threats we have identified that could harm your medical billing business. But first, let us assure you that medical billing companies with the right strategy and the

Earlier this month, we talked about the potential for longer claims cycles as automated detection systems are temporarily derailed by the ICD-10 changeover. We’ll tackle basic processes on how to avoid a Medicare audit and how coding software can guide you to the right levels first: How to avoid a Medicare audit: 1. Use documentation

Canada changed over from ICD-9 codes to ICD-10 codes starting in 2001. The bad news is the implementation did not go smoothly. The good news is we can learn from the mistakes their providers made. ICD10Watch recently outlined eight lessons practice managers may want to incorporate into their changeover plans. Forget about crosswalks. Gillian Price,

The threats to medical billing companies using a traditional model are so severe that most businesses will not survive.  There are times when continuing to do business the way you always have is an acceptable choice. You may not be as successful as some competitors, but you’ll still be in business. This is not one

The medical billing industry is in the midst of a sea change, which means tremendous opportunity for those who understand what’s coming and prepare accordingly. For that, we need to look at where we’ve been (2011-13), where we are now (2014), and where we’ll be in the next couple of years—for five key areas. 1.