Reimbursement

Q&A: Maximizing Revenues and Preparing for Payor Changes

Q&A: Maximizing Revenues and Preparing for Payor Changes

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Keeping abreast of changing payment models and regulations is key to maximizing your practice's finances.

A Physician's Perspective on Opting Out of Medicare

A Physician's Perspective on Opting Out of Medicare

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Katherine A. Roberts, MD, FACE, ECNU, discusses her experience with opting out of Medicare and offers advice to physicians considering doing the same.

Researchers Discuss Barriers to Getting Professional Weight Loss Help

Researchers Discuss Barriers to Getting Professional Weight Loss Help

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A lack of insurance coverage for weight-loss treatments as well as diagnoses of obesity are significant barriers.

Does Coding Affect the Pay Gap for Women Doctors?

Does Coding Affect the Pay Gap for Women Doctors?

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A study suggests that female physicians do not use as many codes as their male counterparts, resulting in a reimbursement gap.

Physician Fee Schedule Changes Proposed by CMS

Physician Fee Schedule Changes Proposed by CMS

Changes have been proposed to the Physician Fee Schedule to transform how Medicare pays for primary care, focusing on improvements in pay for care coordination and planning.

Health Insurance Premiums Will Increase in 2017 Under ACA

Health Insurance Premiums Will Increase in 2017 Under ACA

Health insurance premiums under the Affordable Care Act will rise in 2017, analysts and insurance brokers said.

Medicare Spending Decreased for 2012 Accountable Care Organization Entrants

Medicare Spending Decreased for 2012 Accountable Care Organization Entrants

First full year of Medicare Shared Savings Program contracts is linked to an early drop in Medicare spending.

Guidance for Negotiating Higher Rates from Payers

Guidance for Negotiating Higher Rates from Payers

Compiling the information needed to approach insurance companies is time consuming.

Addressing Inefficiencies in Medical Billing

Addressing Inefficiencies in Medical Billing

Simplification, consolidation, and real time point-of-care information could address the inefficiencies in the medical billing system.

Patient Engagement, Addressing Barriers May Improve Treatment Adherence

Patient Engagement, Addressing Barriers May Improve Treatment Adherence

Tips for increasing patient adherence to treatment plans include patient engagement and addressing barriers to adherence, according to an article published in Medical Economics.

Demand for Medical Office Space Increasing

Demand for Medical Office Space Increasing

Demand for medical office space for ambulatory care is at a high point and looks likely to continue increasing, according to an article published in Forbes.

Tips for Preventing ICD-10 Denials

Tips for Preventing ICD-10 Denials

In order to prevent denials, it is important to code correctly within the International Classification of Diseases, Tenth Revision (ICD-10), with specificity matching documentation, according to an article published in Medical Economics.

Pay-for-Performance May Improve Disease Management in Primary Care

Pay-for-Performance May Improve Disease Management in Primary Care

Pay-for-performance measures have an overall positive effect on disease management, according to new data.

Aetna Now Offering Targeted Diabetes Plans

Aetna Now Offering Targeted Diabetes Plans

Plans will include low copay for specialist visits related to diabetes, free supplies, and financial incentives.

States Urge Doctors to Accept Medicaid Expansion

States Urge Doctors to Accept Medicaid Expansion

Although Medicaid expansion does not work for many doctors, states are trying to find ways to make it work.

Majority of Americans Favor Keeping Healthcare Costs in Check

Majority of Americans Favor Keeping Healthcare Costs in Check

Suggestions include price controls on drugs, hospitals, and doctors.

Health Insurance Coverage of Obesity Treatments Lacking

Health Insurance Coverage of Obesity Treatments Lacking

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Health insurance often excludes obesity treatments, even when target BMI is included in employee wellness programs.

Annual Physicals: What Are the Pros and Cons?

Annual Physicals: What Are the Pros and Cons?

Pros include fostering of therapeutic relationship, while cons include lack of evidence for benefits.

ICD-10 Is Here: Are You Ready?

ICD-10 Is Here: Are You Ready?

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Although ICD-10 will allow greater specificity and clinical accuracy in noting procedures and diagnoses, the transition presents challenges.

Health Insurance Deductibles Increasing Faster Than Wages

Health Insurance Deductibles Increasing Faster Than Wages

One in five workers now have a deductible of $2,000 or more.

Medical Schools Now Teaching Students About Care Costs

Medical Schools Now Teaching Students About Care Costs

Importance of understanding costs due to ACA, prevalence of high-deductible plans.

PCPs Harbor Mixed Feelings About Recent Health Care Changes

PCPs Harbor Mixed Feelings About Recent Health Care Changes

Primary care providers mostly positive about impact of health information technology but are divided on ACOs.

How High-Deductible Plans Affect Physician Care

How High-Deductible Plans Affect Physician Care

Physicians must be able to balance provision of good clinical care with ability to limit costs.

Physicians Often Unaware of Virtual Credit Card Fees

Physicians Often Unaware of Virtual Credit Card Fees

Physicians often unaware of revenue lost to virtual credit cards, and the AMA is advocating for more transparency.

Front Desk Staff Poised to Help Increase Practice Cash Flow

Front Desk Staff Poised to Help Increase Practice Cash Flow

Tips to implement include verification of insurance status, collection at time of service and ease of payment.

How Can Physicians Maximize Payment?

How Can Physicians Maximize Payment?

Intake forms should remind patients of their responsibility for paying bills and collection costs.

First Year of Pioneer ACO Sees Decrease in Medicare Spending

First Year of Pioneer ACO Sees Decrease in Medicare Spending

Total adjusted per-beneficiary spending down in ACO group vs. control group.

AMA Report Discusses End of SGR Formula

AMA Report Discusses End of SGR Formula

Legislation includes provisions such as simplification of reporting programs and incentive payments.

Are Physicians Prepared for ICD-10 Revision Issues?

Are Physicians Prepared for ICD-10 Revision Issues?

Tips to ease transition include contacting vendors and health plans and improving documentation.

Medical Debt Worse for Patients in Texas, Florida

Medical Debt Worse for Patients in Texas, Florida

California and New York fully expanded Medicaid coverage under ACA, but Texas and Florida did not.

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