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Practice Management Alert

Is Your Practice Management System Ready for HIPAA?
The word on the status of HIPAA-compliant practice management systems (PMS) is that you're... Read more
Medicare Physician Fee Schedule Update:
Payments Increase 1.5% for Physicians in 2004 and 2005
Slated 4.5% cut averted by new Medicare bill Higher reimbursements for the new year? Than... Read more
Consult vs. Transfer of Care - Distinguish the Differences
Want more reimbursement for a consult? Check for the 3 R's With physicians using t... Read more
Are You Sure You Want to Opt Out?
Count these little-known costs before you drop an insurance carrier Cutting off ties with... Read more
We Want to Hear From You:
Tell Us Your Carrier Woes
Medical Office Billing & Collections Alert is going to investigate a series of stories... Read more
Don't Lose Out on Hospital Visits
Many practices worry that they are losing money due to improper documentation and missed c... Read more
Reader Question:
Get Paid for IM Flu Shots
Question: With flu season officially beginning Dec. 1, flu shots have been in crazy demand... Read more
Reader Question:
Stand Up to Insurance Retractions
Question: I have a claim from 2001 that was paid by an insurance carrier. They have just n... Read more
Reader Question:
Plan on Keeping Medical Records Long-Term
Question: How long should I keep old medical records?Florida Subscriber Answer: It depend... Read more
Reader Question:
Collect the Lower of 2 Copays
Question: I'm not always sure what to do when a patient comes in with a primary and second... Read more
Avoid Incident-To Billing Accidents
Do you know when to bill using a physician assistant's ID number and when to bill using th... Read more
Put Yourself Under the Microscope Before Your Payer Does
Self-audits can be your best defense against billing-compliance breaches They say that ad... Read more
Don't Let Turnover Turn Your Billing Office Upside Down
Follow these recruitment and retention tips to ensure smooth sailing Attention, billing m... Read more
To Bill or Not to Bill ... That Is The Question
Weigh the pros and cons of in-house billing versus outsourcing The decision of whether to... Read more
We Want to Hear From You:
Tell Us Your Carrier Woes
Medical Office Billing & Collections Alert is going to investigate a series of stories... Read more
Don't Let HIPAA Squeeze Your Cash Flow to a Trickle
What billing offices need to know about HIPAA contingency plans Physician practices breat... Read more
News Flash:
Appeals Missing Documentation Go to the Bottom of the Pile
Take contractor's priorities to heart to win appealsThe double standard for Medicare contr... Read more
Reader Question:
Check Payer Rules Before Launching Clinical Studies
Question: Our practice is interested in participating in a clinical research study. What b... Read more
Reader Question:
Train Staff for Unannounced Audits
Question: I hear so many horror stories about billing offices that fall apart and make dis... Read more
Reader Question:
Avoid Modifier -26 With 93015
Question: Would you explain when it is appropriate to use 93015 and when it would be bette... Read more
Reader Question:
Verify Insurance Coverage Prior to Visit
Question: An oversight at the front desk occasionally results in our office seeing a patie... Read more
Are You Ready To Join HIPAA's Electronic Billing Bandwagon?
Here's what you need to know about the electronic filing final rule.Good news: You've been... Read more
Know What To Do When Good Debt Goes Bad
Let's face it: Bad things happen to good people, and in some cases that bad thing is outst... Read more
Communication Between Doctors And Billers Is Key To Your Practice's Success
Make sure your physicians and billing staff are on the same page.The cornerstone of any su... Read more
Sample This Sample Charity Policy
Not sure where to begin with your practice's charity standards policy? You can use the fol... Read more
What's The Prognosis On Your Diagnosis Billing?
Find out what you can do to get paid for diagnostic tests.Billing for diagnostic tests can... Read more
We Want To Hear From You:
Tell Us Your Carrier Woes
Medical Office Billing & Collections Alert is going to investigate a series of stories... Read more
Expect Cigna To Shape Up And Fly Right:
Learn what a pending settlement agreement means for you.
Does dealing with CIGNA Healthcare make you want to pull out your hair? If so, you're not ... Read more
Reader Question:
Don't Bill Separately For Suture Removal
Question: Is suture removal considered part of an office visit charge, or can it be billed... Read more
Reader Question:
Get Your Priorities In Order
Question: I have mounds of claims to follow up on. How should I go about deciding which on... Read more
Reader Question:
Fee Ticket Myth Debunked
Question: We have one doctor who marks multiple procedure and diagnosis codes, but doesn't... Read more
Reader Question:
Insurance Company Stonewalling You? Know When To Turn To The Patient
Question: I've done everything I can possibly do to get paid from the insurance company, w... Read more
Is Your Appeals Success Rate Less Than Appealing? Here's how to secure a favorable outcome.
A lot of time and energy is dedicated to appealing denied claims, so it's important for bi... Read more
Tracking Denials Will Put You On The Fast Track To Success - Learn how denials are a 'treasure chest' of valuable information.
If you're not paying attention to your denials, you're missing out on information that cou... Read more
'Finders, Keepers' Does Not Apply To Medical Billing - Here's how to correctly manage overpayments and credit balances.
Discovering an overpayment or credit balance in your billing office isn't the same as disc... Read more
Cover Your Bases With This E/M Audit Cover Sheet
Auditing downcoded evaluation and management claims can be a great way to ensure success o... Read more
Use This Log To Track Your Denials
Keeping tabs on your practice's denied claims is an essential tool for saving yourself tim... Read more
News Flash:
2004 Physician Fee Schedule Looks Bleak
The physician community is still reeling from last year's fight to nix a cut to Medicare r... Read more
Reader Questions:
The ABCs of ABNs
Question: Am I allowed to change Medicare's advanced beneficiary notice form to better sui... Read more
Reader Questions:
Know What To Ask When Looking
Question: My practice is thinking about outsourcing our billing. What should I look for in... Read more
Reader Questions:
Get The Scoop On Medical Billing Certification
Question: I'm interested in boosting my marketability as a medical biller. Are there well-... Read more
Reader Questions:
Seeing Double: Know Your Documentation Obligation When Billing
Question: Is it true that in order to bill for a co-surgery, both physicians are required ... Read more
Do Offset Payments Set You Off? Here's How To Manage Them
Offset payments can wreak havoc on your accounting books if you're not careful, so make su... Read more
Wanted:
The Billing Manager To Beat All Billing Managers
Here are the essential qualities to look for in a job candidate.In today's job market, cha... Read more
Be The Best You Can Be:
Compare yourself against this checklist of skills every billing manager should hone.
Being a great billing manager means wearing a lot of hats. To wear all those hats well, yo... Read more
Benchmark Your Way To Billing Bliss:
Learn how self-analysis can boost your bottom line
If you're not paying attention to how the billing and collections activity in your practic... Read more
You Be the Expert:
Banish Modifier -58 Confusion
Question: I'm not clear on the ways modifier -58 can be used, and keep getting denials. Ca... Read more
News Flash:
Billing Offices Breathe A Sigh Of Relief As CMS Relents On Collection Threats
Good news, billers: It turns out you won't have to cough up overpayments arising from the ... Read more
Reader Question:
An Ounce Of Prevention Might Save You A Pound Of Denials
Question: A lot of our payers are starting to bundle the office visit when we bill a 17250... Read more
Reader Question:
Here's A Crash Course On Auto Carriers
Question: We are in a situation where we billed for services in good faith to an auto carr... Read more
Reader Question:
Reaching Your Limits: How To Handle Patients With Therapy Caps
Question: How do you bill patients for physical therapy/occupational therapy when they've ... Read more
Reader Question:
Dispel PCP Pre-Op Perplexity
Question: How do you bill for a pre-operative exam a primary care physician conducts? Shou... Read more
Want to Give a Patient His Walking Papers for Refusing to Pay?, Heres how to do it without paving your way to trouble
 Sooner or later, most medical practices must dismiss a patient who simply refuses to... Read more
Is Billing for Workers Comp More Work Than Comp?, Heres how to make insurers pay up
Workers' compensation claims can be such a huge pain that they can leave your practice's b... Read more
Do Your Financial Policies Stick To the 7-Letter Rule?, Follow these tips to ensure your patients read you loud and clear
You can spend weeks pouring blood, sweat and tears into developing your financial policies... Read more
Heres The Letter Signed, Sealed, Delivered
If the time comes for you to dismiss a patient from your practice for failure to pay, be s... Read more
Not Sure Where to Start on Your Financial Policies? , Use these guidelines as your springboard
If youre in the process of creating your offices financial policies and procedures from sc... Read more
Expect Refunds From Aetna:
Find Out What a Recent Settlement Means for Your Practice
Aetna is about to change the way it does business, thanks to a settlement the company rece... Read more
Reader Questions:
Understand Modifiers for Non-Covered Services
Question: Im about to send a bill to Medicare for a service Im pretty sure will be denied.... Read more
Reader Questions:
Dont Let Staple Removal Create Confusion
Question: Is there a code for removal of staples by someone other than the surgeon, or is ... Read more
Reader Questions:
Even More Reasons to Embrace EMRs
Question: Ive heard that electronic medical records can help cut denials. Is that true?&nb... Read more
Reader Questions:
Make Sure to Include the CLIA Number on Lab Claims
Question: Ive heard that Medicare will never pay for lab codes. Is that true?  &... Read more
Secrets To Reducing Denials:
Experts reveal how you can challenge a bundled claim - and win.
If your carrier is constantly bundling claims you think should be unbundled, they're c... Read more
Think CMS 855 Is Bad Now? One incorrect blank could mean federal regulators at your door.
Do you scrutinize your physician enrollment forms before you send them off to Medica... Read more
Dont Let Hiring Binges Bottleneck Your Claims:
Avoid this A/R pitfall.
You can have the most efficient billing team on the planet, but if they can't bill for... Read more
Beware:
SNF Patients Can Snuff Your Reimbursement: Here's what you need to do protect your bottom line.
If Medicare has been sending you requests for refunds for services your physic... Read more
You Be the Expert:
Keep Physicians And Billers On The Same Page
Question:  The physicians and billers in my office can't seem to communicate ... Read more
READER QUESTIONS:
Modifier -59 Isn't a License to Unbundle
Question: I've heard it's easy to get bundled services paid separately by simply using... Read more
READER QUESTION:
Dont Let CPO Billing Confusion Cost You Money
Question: What are the rules when it comes to billing for care plan oversight for a ho... Read more
READER QUESTION:
Modifier -32 Doesn't Guarantee Increased Reimbursement
Question: My doctor spends a good deal of time on confirmatory consultations, which I ... Read more
6-Step Plan for Restructuring Your Appeals Process
If you don't have a policy for appealing denials, commercial insurance companies won... Read more
Documentation Determines Off-Label Drug Payment
Don't automatically write off off-label drug use in your practice. Payers may frequent... Read more
Identify Denials From 4 Common EOBs and Respond Appropriately
All explanations of benefits (EOBs) for denials are not alike, and if you can't distin... Read more
Choose Wisely:
Capitation Agreements Run the Gamut
Capitation payment plans could make your job easier, but to maximize profit, you shoul... Read more
You Be the Expert:
CMS Unleashes PET Coverage
Test your  knowledge. Determine your solution to this problem befo... Read more
Reader Question:
Catch Up With CCI Edits
Question: We deal with frequent denials because of bundled services. We want to be ahe... Read more
Reader Question:
Opt Out of Trouble When You Opt Out of Medicare
Question: Our physicians have decided to no longer accept Medicare patients. Our offic... Read more
Turn the Tables:
Tailor Third-Party Contracts to Pay You More
You've done everything to improve your collections trained your staff, cleaned ... Read more
Include These Must-Haves in Third-Party Contracts
Your third-party contracts could be limiting your reimbursement because of their ambig... Read more
You Be the Expert:
Capitated Agreements for Your PCP
 Test your knowledge. Determine whether you know what a capitated agreement cov... Read more
Develop a Top-Notch Staff With Positive Reinforcement
Teams don't become champions overnight. Success takes preparation, training and top-no... Read more
Billing Tip of the Month:
Change Colors for Collections
Sometimes all it takes is a new color selection and, instantly, you'll see payments li... Read more
8 Tips for Using Exit Interviews to Improve Compliance
Although hiring interviews can make or break your practice, exit interviews can be equ... Read more
Reader Question:
Review Immigrant Medicaid, SCHIP Eligibility
Question: Do immigrants have any eligibility limitations for Medicaid and the State ... Read more
Reader Question:
Trim Away Nail and Foot Medicare Denials
Question: We've recently received an onslaught of Medicare denials for foot and nail s... Read more
Does Your Collector Make the Grade? Your Guide to Monitoring Job Performance
Whether you're the office manager or billing employee, you have a vested interest in... Read more
Case Study:
Collections Makeover
You may have to implement major improvement changes to get the collections results y... Read more
You Be the Expert:
Supervision for Incident-To Billing
Test your knowledge. Determine how you would handle this situation befor... Read more
Deny Untimely Refund Requests
Don't let payers pressure your office into paying refund requests for mistakes they ... Read more
Sample Letter for Refund Request (See article Deny Untimely Refund Requests.)
Provided by Tonya Bishop, a collections specialist with Alaska Billing Services in Anc... Read more
Hire the Right Auditor
Billing and coding audits are your office's report card, which is why you want a fair ... Read more
Quiz Yourself:
Test Your Modifier Knowledge
Brush up on your modifiers, billers: You are your practice's last line of defense agai... Read more
Test Your Modifier Knowledge (Answers to quiz in article 7)
1. False: You should append modifier -22 (Unusual procedural services) only to your pr... Read more
Reader Question:
Fight for Modifier -25 Payment
Question: Whenever I use modifier -25 on an E/M service, with a procedure code on the ... Read more
Reader Question:
Modifier -57 and Minor Procedures Dont Mix
Question: We use modifier -57 on separately identifiable E/M services during which the... Read more
Tame the HIPAABeast
You can run, but you can't hide: The HIPAAdeadlines are fast approaching. Don't let ... Read more
HIPAA Starters:
Ask Questions,Investigate Policies
Make sure you begin HIPAAcompliance for your billing office with the right set of ques... Read more
Audit Your Audits
If you treat billing and compliance audits like your routine car inspections, you're... Read more
You Be the Expert:
Clear Up Flu Shot Congestion
Test your knowledge. Determine how you would handle this situation before ... Read more
Three Things Every Billing Office Can Do to Help the Practice Ace HIPAA
A practice must take many steps to advance through HIPAAcompliance, and everyone in ... Read more
Is Retro Back? Your Auditing Style Guide
Should you run an audit before or after claims have gone out? The answer depends o... Read more
SAMPLE PRIVACYLETTER:
SAMPLE PRIVACYLETTER:
SAMPLE PRIVACYLETTER: INTRODUCTION AND TABLE OFCONTENTS (from article 6) NOTI... Read more
HIPAA Cheat Sheet for Billing Offices
For your practice to meet HIPAAcompliance, each employee has to pull her share of th... Read more
Reader Question:
When Medicare Comes for You
Question: Our Medicare carrier is doing a lot of prospective audits of regional bi... Read more
Reader Question:
Five Questions about HIPAA
Whether you're the office's HIPAAprivacy officer or just doing what you're told, tes... Read more
When Payers Back Out,Handle Patients with Care
No one likes to inform patients when payers back out of reimbursement but you can... Read more
A Second Look at Collecting Deductibles
There's more than one way to skin a cat and to collect deductibles. Some experts dr... Read more
You Be the Expert:
Know Your Contracts Inside and Out
Test your knowledge. Determine how you would handle this situation before ... Read more
News Flash:
Medicare Alert, OIG Update
Medicare Adopts New Rule for Payments The Centers for Medicare and Medicaid Servi... Read more
New Years Resolutions
Clean Up Preventive-Medicine Claims It's that time of year again the season to nix b... Read more
Reader Question:
Your Checklist for Clean Collections
Question: I want a simple checklist to post on my desk, to give to new billers and t... Read more
Reader Question:
Time-Consuming A Costly Excuse
Question: Many experts suggest collecting insurance and verifying it before hand, but ... Read more
Reader Question:
Reassignment Illegalities
Question: Can independent contracted physicians who work the emergency department re... Read more
Reader Question:
Tactful Ways to Collect Payment for Patients Who Have Died
Question: What's the most considerate way to collect payments for dead patients? We do... Read more
Reader Question:
When Rectal Exams Arent Covered
Question: I'm having trouble getting rectal-exam claims paid by Medicare. Are they bun... Read more
Available Years:  2003  2002  2001