Choosing the right software application for your practice or billing company

November 2007
Choosing a software application to help manage our practice or billing company can be a daunting task. With so many software packages available on the market, which is best suited for your needs now and in the future?
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Terminating the Patient-Provider Relationship

November 2007
In March of this year, I suffered a heart attack and underwent a quadruple bypass surgery and consequently am now under the care of a cardiologist. To make a long story short, my experience with the doctor's office has been poor. I have had appointments moved several times, appointments cancelled, phone calls never returned. When I did speak with someone, I was passed from one person to the next having to tell my story all over again, and the topper of all toppers, I go to have a major test done to determine if I need more surgery and they move the office without telling me about it!
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ELECTRODIAGNOSTIC CODING: Documentation and Coding for EDX Services

November 2007
Electrodiagnostic (EDX) Medicine is a well-known method of diagnostic analysis that is the target of significant scrutiny. This is, in part, due to some rather notable abuses. Nonetheless, even providers who perform these services legitimately are likely to be scrutinized. As such, providers must be certain that each service ordered and performed is well justified, documented, and coded properly. As is the case with any service, proper documentation and coding of EDX testing services will allow you to avoid the potential of an adverse post payment action as well as improve your ability to obtain consistent and appropriate reimbursement for these services.
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Low Cost Ideas That Increase Your Practices Revenue

October 2007
It all comes down to three things; education, communication, and positive behavior. Practices that consistently award and promote these traits are profoundly successful. Every single person in a physicians practice is a part of the revenue process. Learning is perpetual in healthcare and technology. Networking is a great free resource for knowledge and generating increased patient volume. This helps employees feel empowered, proud, and ownership of their career. Professional associations are excellent resources and usually have great benefits for their members.
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Are You Billing the Most Appropriate Setting?

September 2007
There's no denying that payment errors are costly to providers and when those errors are multiplied by thousands of incidents we're talking about serious money. Kim Hrehor, MHA, RHIA, FACHE and Kathy Terry, PhD have written this article for BC Advantage readers regarding this pressing issue.
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Prevention of Silent PPOs

September 2007
Silent PPOs are called by some as being illegal and some are calling their tactics shady. Steve Verno discusses how to prevent dealing with someone you don't know.
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Face to Face with Karen Zupko

September 2007
Karen Zupko is the CEO of Karen Zupko & Associates, Inc. a Chicago-based practice management consulting and training firm with clients nationwide. Karen Zupko & Associates (KZA) has built a respected reputation since 1985 assisting hundreds of clients in many areas. Working on the philosophy that it is better to help clients create management solutions than to call a practice management "doctor" every time a minor problem arises has built KZA to where it is today.
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Taking the fear out of modifier 59

September 2007
I personally think that modifier 59 is one of the best modifiers that exist. It is also one of the most misunderstood modifiers. The objective of this article is to bring to light the correct use of it.
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Testing Your NPI on Medicare Claims Submitted to Carriers and MACs

September 2007
Unlike some health plans, there is no fax number, phone number or special website you need to use to communicate your NPI to Medicare, except including your NPI on your Medicare claims. To date, Medicare has encouraged providers to submit both an NPI and a legacy identifier on claims. At this time, only Fiscal Intermediaries and the CIGNA Idaho and Tennessee carrier are editing the NPI against the Medicare NPI Crosswalk file when the NPI/legacy identifier is submitted. If you are billing these contractors and claims are not rejecting, your reporting of the NPI is successful.
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CMS' New Bounty Hunter Program - RAC ATTACK

September 2007
IMA Consulting has graciously allowed us to publish an interesting article written by one of their Partners, Anthony J. Scarcelli, Jr., CPA that covers an issue that will be facing all Medicare providers sooner rather than later. This is considered to be one of the most significant external "compliance threats" to healthcare providers - the CMS' new "Bounty Hunter" Program- commonly referred to as Recovery Audit Contractors (RACs)!
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Nine-Digit ZIP Codes Required for Some MPFS and Anesthesia Service Payments

July 2007
Medicare carriers and Fiscal Intermediaries (FIs) use the ZIP code on the claim where the service was performed to determine the payment locality for services paid under the Medicare Physician Fee Schedule (MPFS) and anesthesia services.
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How to Win Friends and Influence Physicians

July 2007
Kenneth Engel writes about how you can effectively influence your physician to change their ways to maximize their reimbursement by providing the information that they need in a way that they can relate to.
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The Magic of Modifiers

July 2007
The confusion begins; accurate complete coding drives clean and accurate claims. We know physicians should code their own services; the reality is many do not. Dr. Tom Fasciewski states coding is a "team sport", physician, coder and billing staff should all be involved. Open lines of communication are key, and the most successful practices today work as a team, knowing that the rules and regulations are constantly changing.
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