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Practice Management

ApolloMD Leverages Fathom Autonomous Medical Coding to Save Costs and Accelerate Revenue Cycle for 1,500+ Physician Group

Fathom's AI-based automated medical coding delivers industry-leading automation rates with improved accuracy, reducing ApolloMD's coding costs and alleviating coding staffing challenges

Fathom, the leader in medical coding automation, is providing autonomous coding services to ApolloMD, a multispecialty, 1,500-physician group with a nationwide footprint. ApolloMD is using Fathom's technology to automate coding with exceptional accuracy for more than 2.5 million patients at 88 hospitals and health systems across the United States. Since deployment, the company has achieved industry-leading automation rates, significantly reduced costs, relieved coding staffing challenges, and shortened coding turnaround times from days to hours.

"As one of the most successful clinical staffing services firms in the country, we face enormous administrative medical coding and billing workloads. As we grow, this challenge multiplies," said Dr. Yogin Patel, President of ApolloMD. "After an exhaustive search, we found that Fathom provides the best coding automation technology available that scales seamlessly as we grow."

Fathom fuses the best of deep learning AI and natural language processing to review provider notes and patient charts and instantly determine compliant reimbursement codes – including E/M, CPT, and ICD-10, among other elements – with improved quality and efficiency. ApolloMD's partnership with Fathom included adopting the revised E/M guidelines for Emergency Medicine in January, integrating the latest rules and avoiding the pain and cost of retraining staff. Fathom's medical coding automation platform offers the highest encounter-level automation rate, nearly double that of any other technology, thereby delivering industry-leading ROI.

"At Fathom, we focus on creating healthy communities by automating manual processes intelligently and ensuring the financial well-being of health systems and physician groups," said Fathom CEO Andrew Lockhart. "We are excited that our innovative and powerful coding technology has enabled ApolloMD to meet the demands of their growth while they continue to deliver exceptional physician and patient experiences."

As ApolloMD expands to serve more patients and facilities, Fathom expects to increase the volume of encounters coded and the scale of operational impact for ApolloMD. Patel added, "Fathom is the ideal partner to help us deliver on our vision – healthy clinicians, healthy patients, healthy communities – as we treat millions of patients yearly in hospitals and health systems across the country."

ApolloMD's partnership with Fathom was profiled in a recent video featuring ApolloMD leaders Amy Katnik, COO; Dr. Michael Lipscomb, Chief Quality Officer; and Anthony Mascitti, CIO. View the video on Fathom's LinkedIn page to hear about these executives' experiences firsthand.

About Fathom

Fathom is the nation's leading medical coding automation platform, an AI solution that fuses the best of deep learning and natural language processing (NLP) to automate medical coding with unprecedented accuracy and efficiency. Fathom provides the highest automation rates and the broadest specialty coverage to help clients increase speed and accuracy while reducing costs.

Fathom is backed by world-class investors, including 8VC, Alkeon Capital, Cedars-Sinai, Founders Fund, GV, Lightspeed Venture Partners, and Tarsadia. For more information, visit fathomhealth.com and follow the company on LinkedIn.

About ApolloMD

ApolloMD partners with more than 100 hospitals nationwide to provide integrated, multispecialty physician, advanced practice clinician, and practice management services in emergency medicine, hospital medicine, anesthesia, and radiology. The company's high-touch, solution-based approach emphasizes quality, efficiency, communication, and patient experience. ApolloMD works collaboratively with partner facilities to implement best practices and process improvement across the board in a cost-effective manner. Through ApolloMD Partners, Inc., all eligible physicians and advanced practice clinicians have the opportunity to become owners.

Fathom Media Contacts:

Phyllis Grabot Bonnie Quintanilla

phyllis@clarityqst.com bonnie@clarityqst.com

805.341.7269 818.681.5777

Practice Management

The Role of Artificial Intelligence in Revolutionizing Medical Billing Services for Physicians

Practice Management

Navigating Carrier Guidelines for Optimal Practice Reimbursement

Practice Management

The Evolution of MIPS and Understanding the Upcoming Changes

Practice Management

Proposed Rule for Medicare Physician Fee Schedule CY 2024 Sees Continued Decrease in Reimbursement

Practice Management

Monthly Spotlight on Fraud, Waste, and Abuse:A physician was sentenced to two and a half years in prison for fraudulently obtaining and misappropriating approximately $250,000 from two separate COVID-19 relief programs.

Practice Management

Texas HHSC-OIG is Ramping Up Its Investigations of Medicaid Pediatric Telemedicine Claims:In the state of Texas, Medicaid plays a significant role in providing healthcare services to a large portion of the population. With more than 5.9 million Texans1 (approximately 18.9% of the current population2) enrolled in Medicaid, it is an essential program for qualifying low-income citizens. In Texas, Medicaid costs taxpayers over $40 billion.

Practice Management

Seven Reasons to Standardize Medical Records:The electronic health record (EHR) is widely used for documenting and managing the patient's medical record. In the 1980s, the first web-based EHRs were being introduced and used in healthcare facilities because computer hardware had finally become affordable.

Practice Management

ERISA - Overview for Healthcare Providers: Part I:In the United States, approximately 88% of the employees who are enrolled in employer-sponsored health insurance benefits have plans that are subject to ERISA regulations.

Practice Management

Becoming a Resilient Leader During Trying Times:Resilience is the ability to confidently face challenges, embrace change, recover from setbacks, and bounce back from adversities. This can be extremely difficult for leaders in today's healthcare environment. Increasing your resilience is easier said than done, especially post-COVID. This article provides insight to managers on how to succeed in a competitive, challenging industry.

Practice Management

The CERT Program: What It Is and What a Practice Needs to Know:The Comprehensive Error Rate Testing (CERT) program is a crucial component of the Medicare program that helps ensure the government is paying only for the services and care that beneficiaries actually receive. The program is designed to identify improper payments made to healthcare providers and suppliers under Medicare Part A and B and Durable Medical equipment MACs (DMACs). This article will explore what the CERT program is, how it works, what a practice should do if a CERT request for records arrives, and how the CERT report can be used to help a practice stay compliant.

Practice Management

Harness the Power of Patient Reviews to Elevate Your Practice:When was the last time you made a purchase without looking at product and service reviews? Amazon, Facebook, Google, Netflix, Uber, Travelocity - powerhouse, world-changing organizations all built upon the culture and value of reviews. Healthcare is not immune to the review culture; with our consumerized patient, positive public sentiment is liquid gold and one of your most valuable assets! In fact, 86% of top performing healthcare providers are asking for reviews and feedback after every patient encounter.

Practice Management

Transforming Rural Healthcare Delivery: The Mission and Vision of the Office of Rural Health:For many rural communities, accessing quality healthcare remains a challenge. Geographic isolation, insufficient medical facilities, and a lack of specialized care providers can create significant barriers to adequate care. Recognizing these issues, the Office of Rural Health was established with the goal of improving healthcare in rural areas. This article will explore the mission and vision of the Office of Rural Health and discuss how its initiatives are transforming rural healthcare delivery.

Practice Management

Part 1: Basics of Artificial Intelligence (AI) and Healthcare Compliance:Artificial intelligence (AI) technology has created new opportunities to progress on critical issues, such as health, education, and the environment. In some cases, AI may do things more efficiently or methodically than humans.

Practice Management

Freestanding Emergency Center (FEC) Industry Lobbying Goes to Washington:In early February, members of the National Association of Freestanding Emergency Centers (NAFEC) went to Washington D.C. to meet with various members of Congress to gain support for two items: the continued recognition of Freestanding Emergency Centers post pandemic and for oversight of the No Surprises Act Independent Dispute Resolution process.

Practice Management

The Significance of Not Obtaining Patient/Consumer Consent Before Poaching Data:Now, in 2023, the FTC announced two consent orders related to the prohibited poaching and use of PHI by known third parties and the DOJ announced another settlement under its Civil Cyber-Fraud Initiative.

Practice Management

Seven Measures Developed by the HHS Office of Inspector General (OIG) to Identify Potential Telehealth Fraud:n September of 2022, the Office of Inspector General (OIG) released a report, "Medicare Telehealth Services During the First Year of the Pandemic: Program Integrity Risks," in which they identified that approximately two in five Medicare beneficiaries used telehealth services within the first year of the pandemic to receive healthcare services from a Medicare provider. This is approximately 88 times more often than beneficiaries engaged through telehealth services prior to the pandemic.

Practice Management

The Crucial Role of Negotiating Payer Contracts Every 18 Months for Physician Offices:The healthcare landscape is constantly evolving, with changes in technology, patient care, and the business of medicine all occurring at a rapid pace. One area that is often overlooked but is equally critical to the success and sustainability of a medical practice is the negotiation of payer contracts.

Practice Management

Revenue Cycle Challenges: The Financial Savior:As consumers, we all face challenging inflationary pressures in our lives, with everything presenting challenges to our budgets. Essential groceries and other items are up significantly, posing tremendous financial obstacles for all consumers. The Consumer Price Index (CPI), a closely watched gauge of inflation, recently showed that price increases continue to slow.

Practice Management

Is the Violation Right of Access or Information Blocking? Do You Know the Difference?:The right of access and information blocking are both related to the access and exchange of health information, but they are different in several key ways. HIPAA Privacy/Security and Compliance Officers and Health Information Management professionals need to know the difference. It is important to differentiate between Right of Access and Information Blocking to ensure your organization is compliant with both rules, as well as any applicable state privacy regulations.

Practice Management

Healthcare Compliance: A Unique Opportunity to Impact the Business Side of Medicine:I have been privileged to make my entrance into the world of healthcare, in medical coding, specifically after my first career as an art historian dissolved way back in 2008 due to the recession. Mind you, I have taken all my research skills, writing, communication, and critical thinking strengths along for the ride.

Practice Management

Overcoming Self-Pay Challenges in Revenue Cycle Management:Amid the headlines of labor shortages and hospital closures, many Americans may have missed some positive recent healthcare-industry news: The U.S. reached a new, all-time low in the rate of Americans without health insurance.

Practice Management

FY24 IPPS Proposed Rule Boosts Hospital Payment Rates by 2.8%:CMS proposed a new rule for the fiscal year 2024 Inpatient Prospective Payment System (IPPS), increasing hospital payment rates up to 2.8%. Also, the newly proposed IPPS rule adopts policies that are aimed at advancing health equity.

Practice Management

Empowering Your Front Desk Staff to Improve your Revenue Cycle Management :The front desk is the first point of contact for patients visiting a healthcare facility, and it plays a crucial role in revenue cycle management. The front desk staff is responsible for managing patient registration, insurance verification, appointment scheduling, and collecting payments. Empowering your front desk staff can significantly improve your revenue cycle management and boost your bottom line.

Practice Management

Spotlight on Fraud, Waste, and Abuse - March 2023:The following cases highlight fraud, waste, and abuse (FWA) and serve as a reminder to uphold high ethical standards when providing patient care and services.

Practice Management

12 Tips to Grow Your Medical Practice in 2023:Do you want to expand your medical practice without collapsing? Here are 12 realistic tips to safely and effectively grow your practice in 2020.

Practice Management

The Importance of Selecting the Right EMR and PMS Software:As a healthcare organization, choosing the right electronic medical record (EMR) and practice management system (PMS) software is critical for the success and efficiency of your operations. The right software can streamline patient care, improve data accuracy and security, and reduce administrative burdens, among other benefits.

Practice Management

Recent False Claims Act Cases Shed Light Upon Compliance Scrutiny:As touted by the U.S. Department of Justice (DOJ) and Members of Congress alike, including Senator Chuck Grassley (R-IA), the False Claims Act, 31 U.S.C. §§ 3729, et seq. (FCA) is the federal government's primary tool to root out fraud and put money back into the federal fisc.

Practice Management

Consensus Cloud Solutions to Showcase Healthcare Technologies that Enhance Interoperability at ViVE 2023:Consensus Cloud Solutions, Inc. (NASDAQ: CCSI), the world's largest provider of digital cloud fax technology, will be exhibiting their suite of interoperability solutions at the ViVE 2023 conference in Nashville, Tennessee, March 26-29th. Booth #1020

Practice Management

Five Steps for Provider Credentialing:When your facility hires a new provider, they need to be credentialed. This process allows you to verify their qualifications and skills while getting them approved to work with insurance companies. Medical credentialing is a time-consuming and expensive process that requires complete concentration by a professional. This can use a lot of your facility's resources.

Practice Management

5 Ways in Which Healthcare Data Visualization is Transforming Healthcare:

Healthcare providers can make use of data visualization to assess past and present medical history and improve patient care and outcome.

Practice Management

The End of the PHE: Medicaid, The Omnibus Act, and What Hasn't Been Addressed:An announcement on January 30th, by the OMB (Office of Management and Budget) and the White House, stated that they plan to end the COVID-19 national emergency and public health emergency on May 11th.

Practice Management

Three Ways Medical Groups Can Leverage Digital Self-Service to Drive Growth:That medical groups and health systems share a commitment to delivering convenient, high-quality care in their respective settings isn't surprising. What is eye-opening, however, is that despite their differences in size and structure, they face many of the same business challenges, such as fending off market competitors, acquiring and retaining patients to ensure profitability, and working to alleviate staff burnout.

Practice Management

How to Establish a Business Plan for Your Holistic Practice:Opening a holistic healthcare practice is an exciting and challenging endeavor that requires careful planning and preparation. A business plan is a critical tool that can help you to organize your thoughts, set goals, and create a roadmap for your practice's success. In this article, we discuss steps on how to establish a business plan for your holistic practice and provide some tips for creating a successful strategy.

Practice Management

CMS Announces Increase in 2023 in Organizations and Beneficiaries Benefiting from Coordinated Care in Accountable Care Relationships:Recently, the Centers for Medicare & Medicaid Services (CMS) announced that three innovative accountable care initiatives will grow and provide higher quality care to more than 13.2 million people with Medicare in 2023. More than 700,000 healthcare providers and organizations will participate in at least one of the three initiatives – the Medicare Shared Savings Program and two CMS Innovation Center accountable care model tests. This growth furthers achieving CMS's goal of having all people with Traditional Medicare in an accountable care relationship with their healthcare provider by 2030.

Practice Management

Investigation of Hospitals Hiding Prices from Patients:The Federal Hospital Price Transparency Rule helps Americans know the cost of a hospital item or service before receiving it. Compliance is mandatory. The regulation aims to improve the affordability of hospital care by promoting price competition. However, a low compliance level among hospitals would compromise the operational effectiveness of this regulation.

Practice Management

Top 5 Ways Medical Practices Can Combat Inflation:Inflation is affecting many businesses, but medical practices tend to see the brunt of its effects because of the way payment structures are dictated by insurance payers. Even more worrisome, practices have had to increase wages significantly and the current job market tends to favor employees.

Practice Management

Burnout: A Threat to Our Healthcare System?:The coronavirus disease 2019 (COVID-19) pandemic has generated a substantial increase in the workload of healthcare professionals, leading to physical and mental distress among professionals, resulting in an increase in burnout.

Practice Management

Digital Collaboration Maximizes Efficiency and Reduces Congestion in the Healthcare Ecosystem:CBS reports that excessive financial waste in our healthcare system ranges from $760 billion to $935 billion per year - that's more than the total for annual federal defense spending. The largest portion of this excess is administrative activities; these tasks required of physicians, their staff, and nurses are complex and devour so much time that they waste hundreds of billions of dollars each year.

Practice Management

Expanded Authorization for Non-Physician Providers:The opportunities for non-physician providers (NPP) in radiology practices continue to expand. Recently, the American College of Radiology (ACR) revised its CT and MRI facility accreditation criteria to allow NPPs to be able to directly supervise contrast administration.

Practice Management

12 Tips to Grow Your Medical Practice in 2023:If you are a private practice owner, you may feel it is difficult to attract new patients. By setting a plan and sticking to it, you can set yourself up for success in 2023. Medical practice management requires the collaborative efforts of all team members.

Practice Management

Value-Based Healthcare and Evidence-Based Treatment Rank Highest:Recently, we conducted a new survey on our LinkedIn asking respondents the question, "What do you see as the most important factor that technology solutions can solve to fuel better and more efficient patient outcomes in 2023?"

Practice Management

To Benchmark or Not to Benchmark: That Is the Question:Curiosity is both a blessing and a curse. Wanting to know how you compare to other practices can be so enticing that we are sometimes willing to accept assumptions that are not always supported by the evidence.

Practice Management

Demonstrating the Value of Patient Access in Challenging Times:It's no secret: Most healthcare organizations today are facing significant financial challenges - and there isn't a single culprit to blame. Instead, it's a perfect storm of circumstances fueled by an uncertain economy, workforce shortages, ongoing COVID-19 recovery, and public health issues such as RSV and the impact of delayed care.

Practice Management

The Medicare Advantage Bill Was Crafted in Response to Complaints:U.S. Senators Maggie Hassan, D-N.H., and Dr. Roger Marshall, R-Kansas, have introduced the bipartisan Medicare & You Handbook Improvement Act, which is meant to ensure that when seniors assess their Medicare coverage options, they have the necessary information they need on health plan choices and supplemental insurance.

Practice Management

The Advance Beneficiary Notice or ABN:An Advance Beneficiary Notice (ABN) is one of the most abused forms at a patient visit. When we, as a patient, seek medical care, that medical care is a covered or a non-covered service. If it is a covered service, that means that the service is payable by our health benefit plans.

Practice Management

The U.S. Government and Cooperation Credit in Relation to the False Claims Act and the Federal Anti-Kickback Statute:Those familiar with the healthcare industry have no doubt learned that the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) and the U.S. Department of Justice (DOJ) have identified both the False Claims Act (FCA) and the Anti-Kickback Statute (AKS) as laws critical to thwarting fraud, waste, and abuse. Often, these two laws come together in a FCA case.

Practice Management

Problems Addressed Regardless of the Place or Type of Service:I can't remember if I've recently covered this topic, so one of us (or maybe both of us) may have deja vu today. We're still getting inundated with questions about Problems Addressed regardless of the place or type of service, so whether I've already covered this topic or not, it bears addressing it again.

Practice Management

What Is a Patient Care Policy? (+ How to Write One):If you've never heard of a patient care policy before, then you might ask yourself if your medical practice needs another piece of business writing. The answer is yes; it's a good rule of thumb for your practice to have such a policy.

Practice Management

DME Billing Coverage Limitations and Exclusions :Durable medical equipment (DME) billing is an essential aspect of revenue cycle management in the healthcare industry. As the industry evolves, DME has grown in importance and now serves millions of patients. However, managing the billing processes and reimbursements associated with DME can be time consuming and labor intensive.

Practice Management

How to Reduce Patient Collections in a Medical Office:Putting on the dreaded collections hat is a necessary evil that every medical office can relate to. You can run a tight ship, doing your very best to collect payments at the time of service, but because of the complexities of medical billing and emergent situations, there will always be times when collecting every patient's payment is an impossibility.

Practice Management

What Are SOAP Notes? (And Why They’re Important for Insurance Billing):Healthcare documentation is a critical component for your holistic practice, both in terms of delivering great care to your patients and for insurance billing purposes-not to mention the importance of having some form of documentation in the event of a legal situation.

Practice Management

Let's Talk about Weed (As in the Doctor):Early September marked my 33rd year on the administrative side of healthcare. This followed my 56th birthday in April when I officially entered the realm of "pushing 60."

Practice Management

DENIED! CO 22-This care may be covered by another payer, per coordination of benefits?!?:Coordination of benefits can be described as when two or more insurance plans work together to determine the order of coverage liability. This coordination between plans exists to avoid duplicate payment, which could result in a provider receiving payment in excess of the services provided and the total amount billed.

Practice Management

A Cautionary Tale about Personal Injury Protection, Health Insurance...and Lawsuits:Medical providers who treat individuals for injuries sustained in motor vehicle accidents (MVAs) are frequently tasked with identifying the proper insurance carrier that is responsible for payment.

Practice Management

Medicare Patients and Stark Law: What You Need to Know:If your medical practice treats patients covered by Medicare, then you already know that there are countless regulations you need to closely adhere to in order to avoid any issues with the government.

Practice Management

Implications of the Federal Trade Commission's Report on Artificial Intelligence In the Healthcare Sector:No doubt, most people have heard of the phrase, "You are what you eat," which means that what we eat and our lifestyle choices impact our health and well-being.

Practice Management

Patients Charged Expensive Out-of-Pocket Fees as Doctors Stop Bulk Billing:Perth mother Jayme Lees has been bulk billed by her General Practitioner (GP) for the past six years, but when she took her newborn son for a check-up in June, she was hit with a hefty, unexpected fee.

Practice Management

Telehealth Here to Stay, But Technology Needs to Catch Up:Patient care in a post-COVID-19 world is significantly different for providers who are embracing virtual care options, such as telehealth and asynchronous texting.

Practice Management

Why Medical Practices Need a Mobile-Friendly Website:People worldwide are increasingly using a range of devices to access the internet. Nowadays, it's not safe to assume that all your website visitors use a desktop or laptop computer-they’re more likely to use tablets or smartphones.

Practice Management

Thoughts Had...Lessons Learned ® The Selling of Marcus Welby, M.D. - Part 2:The basic economic business model as presented by Adam Smith in his book on capitalism, The Wealth of Nations, is shown below. Adam Smith was a Scottish social philosopher and political economist who wrote a major influential book on capitalism in the 1700s. You just never know where and from whom you are going to find your answers.

Practice Management

Thoughts Had...Lessons Learned ® The Selling of Marcus Welby, M.D. - Part 1:The first article I ever wrote for BC Advantage (BCA) Magazine was for the March/April 2017 issue. It was wishfully titled, "An Alternative to Private Practice Extinction."

Practice Management

Is Now the Right Time to Start a Medical Billing Company?:Occasionally, I receive a call in my office asking my advice regarding whether or not I think it is a good time to start a medical billing company. I never answer the question directly; rather, we have a discussion outlining the positive and negative aspects of running a billing company in today's healthcare environment.

Practice Management

You Play a Vital Role in Protecting the Integrity of the U.S. Healthcare System:The U.S. healthcare system relies heavily on third-party payers to pay the majority of medical bills on behalf of patients. Healthcare insurance fraud is a pressing problem, causing substantial and increasing costs in medical insurance programs.

Practice Management

Audio-Video Telehealth, Mobile Device Management, and You:This article addresses how to track telehealth policies while addressing HIPAA compliance and mobile device management as the United States enters a post-pandemic era.

Practice Management

Best Practices for Recruiting Front Desk Medical Staff:As medical practices bounce back from the pandemic, many are finding it challenging to recruit and hire great employees, including front desk staff.

Practice Management

Prepare for Telehealth After the End of Public Health Emergency:The state and federal Public Health Emergency (PHE) declarations related to the COVID-19 pandemic created wide latitude for providers to render services via telehealth in order to prevent the higher risk of in-person contact for patients, providers, and staff.

Practice Management

Outsourcing Strategy 101: Crucial Questions to Ask Healthcare Billing Companies:Healthcare billing companies are excellent partners to the mainstream medical industry-hospitals and independent or group clinics.

Practice Management

FACT SHEET: The Biden Administration Announces New Actions to Lessen the Burden of Medical Debt and Increase Consumer Protection:Vice President Kamala Harris announces reforms across four areas to ease the burden of medical debt, giving more American families the opportunity to thrive.

Practice Management

Improving the Patient Experience with Electronic Patient Statements:The most important part of any healthcare practice is helping patients. The second most important part is getting paid. Offering electronic patient...

Practice Management

Five Facts about Split Visits:Got five minutes? You can learn five things about the crazy 2022 rules for Split Visits. Hopefully, this will end a lot of the confusion around these relatively new rules.

Practice Management

Offsetting Staffing Shortage-Induced Revenue Loss:Exacerbated by pandemic-induced burnout, the Great Resignation, vaccine mandate-driven terminations, and rising retirement rates, the chronic shortage of billing, coding, and audit professionals will continue to worsen over the near future.

Practice Management

Improving Accounts Receivable for Effective Revenue Cycle Management:Collecting amounts that have been billed or accounts receivable is essential for successful revenue cycle management.

Practice Management

The Importance of Mental Wellbeing in Modern Healthcare Practices:Supporting the mental health and wellbeing of healthcare workers should be the number one priority of every healthcare manager and practice owner. The importance of essential workers and first-line medical staff is evident now more than ever.

Practice Management

The Road to Professional Success and Recognition!:The Professional Association of Health Care Office Management, Inc. (PAHCOM, pronounced "PAY-COM") has been providing efficiency concepts, productivity, and networking knowledge since 1988.

Practice Management

Using Software to Grow Your Medical Billing Company:Here's a simple truth: the faster you can get your customers paid, the more popular your medical billing company will be. Now here's another one: no matter how effective your team is, you will only ever be as efficient as your software allows to grow your medical billing company.

Practice Management

No Surprises Act Compliance:The Department of Health and Human Services published three parts to the No Surprises Act towards the end of 2021, which took effect January 1, 2022.

Practice Management

8 Tactics to Improve Revenue Cycle Management for Your Practice:Whether you're part of a larger hospital or run your own private practice, improving revenue cycle management means improving your bottom line.

Practice Management

Insulate Your Revenue Cycle Management Process from the Surprises of the No Surprises Act:Last year, the U.S. government announced an interim final rule (IFC) related to the Surprise Billing Act. The rule defines the No Surprises Act's requirements for group health plans, carriers and payers, medical service providers, and other ancillary services.

Practice Management

What's Your EQ?:Most people have had interactions with physicians who are intelligent, nice people but have awful bed-side manners. Or a practice manager that seems oblivious to staff members' feelings or personal situations.

Practice Management

No Surprises Act and Good Faith Estimate Considerations for Behavioral Health Providers:Overview: Enacted as part of the Consolidated Appropriations Act of 2021, Pub. L. 116-260 (Dec. 27, 2020), the No Surprises Act (NSA) and the related regulations, which became effective January 1, 2022, should have a positive impact for patients.

Practice Management

Coding for a Performance of an X-ray Service vs Counting the Work as a Part of MDM:When x-rays are audited on the same date as an E/M encounter, we have one of three decisions to make about the work that went into the radiological exam when the practice owns x-ray equipment and does their own interpretations internally.

Practice Management

How to Negotiate Physician Payer Contracts :There is a dynamic shift in the healthcare arena where insurance payers are willing to negotiate reimbursement rates for small and mid-size physician groups. The reason for this is because insur-ance payers are starting to realize that the 'bread and butter' of their network consists of small to mid-size groups (1-10 physicians) and they have been ignoring this subset for far too long.

Practice Management

What's the difference between Credentialing and Contracting a Provider?:Credentialing is the formal process of verifying a provider's qualifications. This ensures that doctors and nurses have the proper training and experience to provide the highest level of care to patients. The provider credentialing process is completed by verifying all provider documents and ensuring that they are valid and current. Most health insurance companies will not even offer reimbursements if providers lack medical credentialing.

Practice Management

How Anomaly Detection Can Fight a Nearly $300B Healthcare Issue:In healthcare, just as in life, no one likes losing money-particularly when you don't know why it's happening.

Practice Management

Employee Training: An Investment That Can Benefit Healthcare Organizations Long After the Employee Has Moved On:Interview with Revenue Cycle Management Experts, Taya (Shawntea) Moheiser and Kem Tolliver:

Practice Management

Challenges for 2022:Welcome to a brand-new year! It looks like it is stacking up to be a very interesting and possibly one of the most challenging for the medical billing industry. There is an overabundance of issues facing us in 2022 and beyond; we need to develop a strategy to ensure we continue on the pathway of success.

Practice Management

So Hard to Say Goodbye: Part VII of the Back to Basics Series:Ending the Provider Patient relationship is never easy, nor should it be. From the patient's perspective, without regard to the reason for separation, it is very much like a bad break up; you're angry, likely feel misunderstood, and your old partner still has a box full of your personal items (think PHI).

Practice Management

Why Quality Documentation Matters:If you work with provider claims in a medical office, then you have probably heard the phrase, "If it isn't documented, it wasn't done."

Practice Management

Managing Virtual Teams:It is hard to believe, but at the time of printing this article, it has been over 600 days since the country shut down for the first time. In March of 2020, COVID-19 changed our business lives forever. The last live seminar I gave was in Las Vegas in February 2020, and since then, it's been the world of Zoom, Microsoft Teams, GoToMeeting, and other similar platforms.

Practice Management

Talking the Talk, Walking the Walk - An interview with Shannon DeConda:Sean Weiss, a DoctorsManagement Partner and Vice President of compliance, spoke to Shannon DeConda, President of NAMAS (National Alliance of Medical Auditing Specialists), as well as a Partner in DoctorsManagement.

Practice Management

Maximizing Revenue and Relationships in the Age of Patient Consumerism: Modern Solutions to Boost Revenue Collection:Maintaining financial stability is a challenge for any healthcare provider's office, but especially in the industry's current age of patient consumerism. The increases in regulation and the transparency of medical care processes have given rise to healthcare consumerism, wherein newly empowered patients have control over their healthcare experience.

Practice Management

How Can Changes in Telemedicine Financially Impact Your Practice?:The rapid evolution of telehealth services has helped keep medical practice virtual doors open to meet their patients' health needs during the pandemic. But with new utilization comes cautionary areas from a billing standpoint, and it's important to stay current on updates and compliance protocols to promote revenue growth and avoid financial loss.

Practice Management

MIPS - What Practices Need to Know to Avoid Financial Penalties:By law, CMS is required to structure the MIPS program such that 1 out of 2 clinicians will be penalized each year.

Practice Management

From Multi-Generational to Intergenerational: Keys to Managing/Working in Healthcare Today :When my daughter, Victoria, was little, she was looking at some old albums in our garage. She was staring in awe at the Journey, Styx, REO Speedwagon, and others. She was commenting on how pretty the artwork was when an album slipped out.

Practice Management

Waiving Copays Associated with Medicare - Just as Illegal Now as it Was in 1994:On December 19, 1994, the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) published a Special Fraud Alert in the Federal Register related to the waiver of copays, with the intention of alerting the public about "its concern about possible widespread and abusive health care industry practices, and seeking wider dissemination of information to the general public."

Practice Management

September is Alzheimer's Month:Alzheimer's disease is a progressive and irreversible neurologic disorder that affects areas of the brain involved in thought, memory, and learning. Though the words Alzheimer's and dementia are often used interchangeably, dementia covers a group of brain disorders that cause problems with thinking, memory, and behavior.

Practice Management

The Power of Collaboration:Gone are the days of Norman Rockwell, Mayberry, and an apple pie for the good doctor as a token of appreciation for tending to little Bobby's banged up knee. Today's medical practice faces an onslaught of regulation, liability, and the newcomer to the party: cybersecurity.

Practice Management

Fixes for Healthcare: PART TWO:In my last article, I outlined four ideas that could help streamline our complex healthcare system. To recap, they were:

Practice Management

How to Properly and Safely Terminate an Employee:As a Medical Office Manager, there are few actions as uncomfortable as firing an employee. Yet, after verbal warnings, write-ups, and other corrective actions, you know when this time has come to gather your documentation and make difficult decisions about how and when to proceed.