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Issue #2 - October 24, 2012

Practice Management Tips and Resources

Track Denials to Speed Revenue Stream

Having clear policies and processes for handling claims denials can affect your bottom line by improving your revenue cycle, decreasing staff costs, and increasing cash flow.

In too many circumstances, denials are either resubmitted or ignored without really considering the causes. As a result, ongoing revenue capture is not optimized and the practice spends excess money on inefficient processes.

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Interoperability a Key to Effective Communication

When implementing a new electronic health record (EHR) system or updating an existing one, interoperability will be a key for success in efficiency and quality in your health care system.

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E/M Outliers: Why You Should Care
By Mary LeGrand, RN, MA, CPC, CCS-P

Imagine an auditor looking at the distribution of evaluation and management (E/M) services for your practice. What would the auditor find as he or she compared your practice's usage patterns to other physicians in the same specialty in your state?

If a provider is an outlier on an E/M benchmark comparison—for instance, because he or she uses more consultation codes or more upper level codes—it is not necessarily a bad thing. In many cases, the variation can be explained legitimately (for instance, when a spine surgeon who only sees patients on referral is compared to general orthopaedic surgeons). Nevertheless, being an outlier will prompt questions. Hopefully, you will have answers to explain the deviation, supported by excellent documentation.

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In This Issue
Track Denials
E/M Outliers

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