Healthcare Archive

Accountable Care Organizations (ACO) – What You Need to Know About Setting Up an MSSP ACO

Accounting Care Organizations are required to submit the names of ACO participants. Examples of such participants include a group and solo practice, a pharmacy, an acute care hospital, a Critical Access hospital, a federally qualified health and a rural health center, and other such entities that are enrolled with Medicare and bill Medicare for services.

Leverage Your Practice to Generate More Revenue

I have said to many physicians, the best revenue is the revenue you did not directly generate.  That is where leveraging your office resources comes in.  A physician always thinks to generate more revenue they need to work harder but that is not always the case.  Diagnostics are an excellent source of indirect revenue.  Diagnostics

Sandy Makes Proper Vaccination Storage Difficult

First of all, I hope those that experienced Superstorm Sandy are safe and working on returning towards “normalcy.”  Personally, I’ve lived in New Jersey for 27 years, and this is by far the worst natural disaster I’ve lived through.  As bleak as things may currently seem for those hit the hardest, please know things will

Medicare Wellness Visits: One Visit a Year… But 3 Codes?

Thanks to the Affordable Care Act, Medicare is (finally) covering yearly preventative, or “wellness,” visits for patients; however, the annual visit is actually separated into three different encounters.   Although each visit is largely similar, there are a few minor details separating each visit, and, as you know, these minor details must be followed as it

Get Your Flu Shots Here!

After assisting with the preparation and presentation of the flu shot webinar I truly believe that, armed with reminder calls, providers have a fighting chance of bringing in patients who would otherwise stop in a store to receive their flu vaccinations.  This idea really hit home when I visited family and friends in Washington D.C.

Relative Value Units/RVU’s, Whats the Big Deal?

Relative Value Units have been utilized to drive CMS reimbursement calculations since the early 1990’s. There are unique RVU values associated with each CPT billing code charged by a provider. Those values are defined for Practice RVU, Work RVU, and Malpractice RVU. These values are driven by a physician’s time, cost, and effort to provide

Grandfathered Plans under the Affordable Care Act

One of the more important and popular provisions of the Affordable Care Act is the expansion of access to certain recommended preventive care services – including flu shots – for patients at no additional charge to them. However, many health plans that existed on the day the ACA was enacted, March 23, 2010, known as

The Good News About Flu Season

The summer is winding down and we are approaching flu season. Nevertheless, there is good news for patients and providers regarding the flu: The flu shot is now covered (with no corresponding patient responsibility) by more plans than ever before. First, as a quick reminder, Centers for Disease Control and Prevention (CDC) makes a general

Medical Office Coding – Its not about the shoes!

Over the years as an administrator and consultant I have been regularly surprised by some of the methodologies used by physicians to assign a CPT code for a patient encounter. My favorite was a cardiologist from Ohio who always used a 99213 unless the patient had beat up shoes, in those cases he would give

Proactive Patients Seeking Healthcare Information Prefer Surfing the Web Over Turning Pages in a Book

A new study, from the University of California, Davis shows that patients prefer using the internet to obtain healthcare information over asking friends or using reference books.