One thing I ve noticed with regard to ACO formation is that the ACO creates its agreements and then presents them to the physicians for participation and execution. The physicians,... Read More >
nbsp The first round of medical loss ratio MLR rebates payable under the Patient Protection and Affordable Care Act PPACA P.L. - have now been either recently received or are... Read More >
nbsp Experts continue to worry that not enough health professionals and others who have contact with patients will get the flu vaccine. Data shows that approximae of health care personnel... Read More >
nbsp Most recently available are annual statistics of OSHA medical facilities non-hospital which show a rate of citations equaling , . in fines. Could this happen to you? Is your... Read More >
nbsp When I see and read mission-type statements by healthcare organizations, I often wonder if the organization really lives and breathes their vision, values, and or mission on a daily... Read More >
nbsp The best negotiation is a win-win scenario for both of the parties to the negotiation, one where each party walks away from the negotiation table knowing something was won.... Read More >
nbsp Leverage is a major pathway to successful negotiation of a managed care contract. The ability to negotiate or renegotiate a managed care contract is often determined by the amount... Read More >
Following is an example of our strategic planning self-assessment. The purpose of these self-assessments is to give you a concise checklist of best practices in a clinical practice. This checklist... Read More >
Did you know that payment accuracy rates among insurance companies have dipped as low as percent according to the American Medical Association s Health Insurance Report Card, a survey published... Read More >
Although the final rule on the proposed ICD- deadline change has yet to be published, it is important to continue planning for the transition to ICD- . The switch to... Read More >
nbsp A medical practice should determine whether it makes sense for the practice to continue its participation in the plan by answering the following questions this should be done on... Read More >
nbsp After a managed care contract is signed, it is important to make sure the office handles these payors correctly, handles their patients correctly, and makes sure the office continues... Read More >
nbsp These are excellent tips to employers provided by the Texas Workforce Commission I think these practical tips apply to any physician medical practice no matter what state you practice... Read More >
nbsp When it comes to healthcare reform, depending on who you talk to, it s either the greatest thing since sliced bread or Darth Vader s evil cousin. Here, in... Read More >
Remember if left unaccounted for and or if a lack of oversight exists, an employee can set up a phony vendor account s . Payments made to this phony vendor... Read More >
nbsp I was reviewing a CIGNA managed care contract for a client recently and came across two typical provisons concerning underpayments and overpayments. Here is the underpayment clause in the... Read More >
Know where to look Staff can help recruit, too, so ask them for suggestions. A current staff member may have a friend who would fit in well with your operation.... Read More >
nbsp At a Chicago summit highlighting a new high-tech war against health care fraud, Health and Human Services HHS Secretary Kathleen Sebelius and Attorney General Eric Holder recently discussed how... Read More >
nbsp The IRS has created a great calendar to keep up with due dates and also to provide tax advice. The calendars come in online form, desktop form, and paper... Read More >
nbsp Here s some proof from CIGNA I read yesterday Cigna partners with Houston doctors for collaborative accountable care Cigna has partnered with doctors affiliated with St. Luke s Health... Read More >
nbsp Will the ACO concept move in to the private payer arena? Seems likely. Many private insurance companies are embracing the same concepts that underscore the Medicare ACO initiatives and... Read More >
nbsp The Medical Group Management Association www.mgma.com recently published results of its annual member survey and listed the top challenges facing physician practices today. They are listed below. Take a... Read More >
nbsp According to an article in the Arizona Republic posted on AZcentral.com, Health Net of Arizona has begun offering a new narrow network HMO product to employers in conjunction with... Read More >
nbsp The number of accountable care organizations ACOs has increased by percent in the past six months, with models identified in states, according to a study by Leavitt Partners. http... Read More >
nbsp The Department of Labor posted a new publication called The Employee s Guide to the Family and Medical Leave Act on its website www.dol.gov whd fmla employeeguide.htm . The... Read More >
nbsp Here is an article from the recent electronic version of Medical Economics that was produced from a persentation I gave at the annual meeting of the National Society of... Read More >
nbsp With the Supreme Court upholding the Affordable Care Act, you should continue preparing for the following provisions that become effective in employer-provided health Flexible Spending Arrangements FSAs will be... Read More >
nbsp Earlier this month, OCR revealed some preliminary results of these pilot audits at a National Institute of Standards and Technology conference. OCR presented audit results for covered entities. The... Read More >
Here are the most common mistakes I see made in physician medical practices that result in insurance payment denials are these common in your office? Registration Errors Denials often occur... Read More >
nbsp Continuing efforts to identify and stop Silent PPO arrangements is essential. At a minimum, physicians signing PPO contracts should ensure the following That discounts will be extended only to... Read More >
Subscribe to my blog
As a top advisor to physicians, I help increase practice profits by delivering hands-on, expert medical accounting/tax support, practice counsel, and revenue-building strategies. Read More >
