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RCM + Billing - Office Practicum

RCM + Billing

20 Mar

Posted at 20:53h in Financial, RCM + Billing by

Very few things about medical billing are straightforward, but it’s especially true in pediatrics. Proper coding, modifiers, and changes in Medicaid rules and payer guidelines can turn a simple office visit into a minefield of dependencies. Add staffing shortages and the challenge of finding qualified medical billers to the mix, and it further exacerbates the stress of billing for pediatric practices. When it comes to running a pediatric practice, the days of “one size fits all” are over. You can no longer thrive and work efficiently using a generic, non-specialty-specific EHR, and the same is true for billing and revenue cycle...

02 Feb

Posted at 14:45h in Financial, Growing Your Practice, RCM + Billing, Reporting, Staying Independent by

If a pediatric practice has some extra down time, pause and remember the financial health of your practice starts with having an appropriate fee schedule. While contractually the payers determine how much they are going to pay you for each service you provide, it starts with how much you charge.  Scheduled Processes and Procedures At a minimum, at the beginning of the year, your practice should have a scheduled process and procedure for updating your fee schedule so you can be sure you are not leaving money on the table (and in the insurance company’s pocket.) The AAP has resources for pediatricians...

15 Dec

Posted at 19:23h in Financial, RCM + Billing, Reporting by

As a pediatrician, your primary goal is to deliver the best possible healthcare to your patients. Just as it's important for your patients to have regular check-ups as part of their wellness, it's also critical to regularly evaluate your pediatric office's financial health. But how? There are some key analytics that you can consistently examine to stay on top of your practice's financial well-being, while successfully planning for the future.  Whether your billing is done in-house or outsourced, here are 3 data analytics you should always have included in your monthly and yearly billing reports. 1. Number of Days in Accounts Receivable (A/R) You...

16 Oct

Posted at 03:15h in Growing Your Practice, RCM + Billing, Staying Independent by

You’ve decided you’re ready to spread your entrepreneurial wings. You're going to open your own pediatric practice. While it’s an exciting time, it’s also busy with planning. You’ve got a checklist full of items like credentialing providers with payers, securing financing, choosing a location, purchasing technology, hiring staff, ordering supplies and furniture, and preparing forms and processes. Another important area to tackle before officially launching your new practice? Billing. It's one of the most critical elements of your business. Without a good billing system, you won't get paid appropriately. And a practice that's not profitable will quickly fold in the ever-changing world...

13 Aug

Posted at 06:05h in Financial, Growing Your Practice, RCM + Billing by

When reviewing (or developing) your revenue cycle management plan, don't overlook the first steps: making sure all your providers are appropriately credentialed with all your payers and associated products. Credentialing and Provider Enrollment are more than just arduous tasks of paperwork; without them, claims aren’t paid and revenue suffers. Opportunities to grow your practice and strengthen your revenue depend on a solid credentialing and contracting game plan. Key functions that help your practice receive proper reimbursement from insurers: Payer Product Analysis: Most insurers offer multiple products and these products can change annually, especially Medicare Advantage, Medicaid HMO, and ACA plans. Review your...

30 Jul

Posted at 17:58h in Growing Your Practice, RCM + Billing, Staying Independent by

A frazzled mom walks into your pediatric clinic. She approaches the check-in desk, and your receptionist notices dark circles below wet eyes, red from crying, possibly even during the drive to the office.  The screaming toddler on the mom’s hip is not so interested in disguising his anguish. He wails in pain as he tugs on his ear, not afraid to let the tears fall freely. Even those staff members behind the check-in desk, standing at the hallway scale, or walking a patient to an exam room can hear the little guy. After checking in the fidgety little boy, the receptionist sees...

21 May

Posted at 17:24h in RCM + Billing by

Do you lie awake at night worrying about your pediatric practice’s billing processes? Are you concerned about what will happen when your reliable, long-standing staff biller decides to retire? For example, who’s going to ensure you’re billing for all services you perform such as every strep test has an accompanying visit billed. And who’s going to keep track of the constant, ever-changing payer rules that can result in significant financial hardships, if you’re relying on inadequate, inexperienced or unmotivated billing staff? If these are your thoughts, there are steps you can take to address these problems and achieve better pediatric billing...

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