How To Avoid Common Medical Billing And Coding Errors in 6 Steps

Comment

How To Avoid Common Medical Billing And Coding Errors in 6 Steps

Operating a medical practice is more than just practicing medicine. Whether you’re a veteran physician with an established practice, or a novice practitioner branching out for the first time, the business side of your medical office can be overwhelming. You have two full time jobs…business owner and doctor.

You don’t have to do it alone. Medical practice management consulting helps independent practices achieve their goals without sacrificing patient care quality. They guide you through the business side of practicing medicine.

Here are 5 benefits you can expect from a practice management consultant.

Comment

5 Reasons to Hire A Medical Practice Management Consultant

Comment

5 Reasons to Hire A Medical Practice Management Consultant

Operating a medical practice is more than just practicing medicine. Whether you’re a veteran physician with an established practice, or a novice practitioner branching out for the first time, the business side of your medical office can be overwhelming. You have two full time jobs…business owner and doctor.

You don’t have to do it alone. Medical practice management consulting helps independent practices achieve their goals without sacrificing patient care quality. They guide you through the business side of practicing medicine.

Here are 5 benefits you can expect from a practice management consultant.

Comment

Choosing Merchant Services for Your Medical Practice

Comment

Choosing Merchant Services for Your Medical Practice

Payment processing is one of those things that should just work. You shouldn’t really need to spend much time worrying about it and no news is good news right? The problem is that the industry is largely predatory when it comes to contracting and rates, especially with medical offices. Worse still, support is quite frequently outsourced and/or has pretty low bar for the definition of support/services.

While many medical offices run like a business, they have drastically different needs for payment processing. The average business worries about protecting customer payment information. For a medical practice, however, a breach in security compromises patient medical information. Medical offices also have strong use cases for mobile payments, embedded statement payment options, online payment options and beyond.

Comment

10 Common HR Issues at Medical Practices (And How to Solve Them)

Comment

10 Common HR Issues at Medical Practices (And How to Solve Them)

Your practice’s most valuable asset is its people. They determine the type of practice you run, whether it’s friendly and efficient, or cold and unproductive.

Many smaller practices mismanage human resources. They don’t have a separate HR specialist or department, and the practice manager must negotiate HR issues and complaints.

Without proper handling, HR issues reduce office productivity and create hostile work environments. Below are the most common HR issues that plague medical practices - and how to fix them!

Comment

How to Hire the Right Staff for Your Medical Practice

Comment

How to Hire the Right Staff for Your Medical Practice

In a fast, demanding medical environment, an empty position can devastate productivity.

Hiring an ill-fitting staff member further damages productivity. Never mind the precious time training a person who can’t complete the job correctly, doesn’t fit culture, or is mis-aligned with expectations…the wrong hire creates even more work for the senior members, and you have to repeat the process as soon as you decide to move on and scrap the wasted resources.

Here are 8 steps to hire the right staff member for your practice (and save your productivity)!

Comment

Accounting Services for Medical Practices - An Overview

Comment

Accounting Services for Medical Practices - An Overview

Businesses need a solid accounting system and cash controls to succeed. While medical practices differ from traditional businesses in many ways, a practice with unbalanced books or without an eye on its books at all, will fail.

For many practice owners, accounting can be an enormous hassle. Generating financial reports and balancing books detracts time and money from medical services. Why should aging receivables and late payments prevent you from providing quality patient care?

Comment

How to Be a Good Practice Manager in 8 Steps

Comment

How to Be a Good Practice Manager in 8 Steps

A medical practice needs more than just doctors to function at a high level — it’s more than just a patient treatment facility…it’s a small business and a community, with all the associated complexities. It needs strategic vision, a business plan, a guiding hand, a day to day leader and a right hand to the physican. Without a good practice manager, a medical office risks reduced patient care quality, reduced revenue, reduced office culture, or even practice closure.

Comment

Major Differences between ICD-9 and ICD-10 that affect Medical Billing

Comment

Major Differences between ICD-9 and ICD-10 that affect Medical Billing

Far from just a routine coding update, the switch from ICD-9 to ICD-10 altered the very structure of coding procedure. While such a huge change may seem like a hassle, your practice can code more precisely and get paid easier with ICD-10. Here are the biggest differences between ICD-9 and ICD-10.

Comment

8 Ways to Improve Medical Accounts Receivable Management & Cash Flow

Comment

8 Ways to Improve Medical Accounts Receivable Management & Cash Flow

Does your practice’s cash flow suffer because of high accounts receivable? If so, you are not alone - many practices experience revenue delay for the same reason. Below, we explore some of the most common problems - and solutions - in managing accounts receivable.

Comment

5 Tips for Improving Medical Office Efficiency

Comment

5 Tips for Improving Medical Office Efficiency

Improving medical office efficiency improves patient satisfaction and increases your practice’s bottom line. This list includes the top five ways to reform patient flow and boost revenue.

Comment

Auctus Summer Meeting 6/21-6/22

Comment

Auctus Summer Meeting 6/21-6/22

We are so pleased to share a look into our first ever all company outing!

Not only is our group full of incredible and unique people; but seeing us all together in one place was one of the more proud moments of the company thus far. 

So, let’s begin!

Comment

The Best Dermatology Billing Software Programs

Comment

The Best Dermatology Billing Software Programs

With many medical billing softwares on the market, it is difficult to select the right one. There are numerous options to consider. Do you want a comprehensive package? Or just revenue management? Do you need iPad compatible software? Or just desktop? Lastly, do you want general software or one for your medical specialty?

Comment

6 Benefits of Medical Billing Outsourcing

Comment

6 Benefits of Medical Billing Outsourcing

Medical billing is a complicated affair. Claims must be filled out completely, correctly, and on-time. There are thousands of different claim codes for each medical sub-section, and hundreds of reasons for claim denial.

The process is time-consuming. With the burdens of running your own practice, billing can become overwhelming.

When it comes to getting help, you’ve got 3 options: hire an in-house biller, assign billing to your front office, or outsource your billing.

Comment

Understanding and Communicating Your Network Status

Comment

Understanding and Communicating Your Network Status

How do I know if I am in network with my patient’s insurance plan? Simple question with a not so simple answer…

Comment

5 Considerations When Selecting a Physician Billing Service

Comment

5 Considerations When Selecting a Physician Billing Service

Picking a billing service can be difficult.  There are many options...some of which are less than great.  Choosing the wrong team can unfortunately have costly consequences as well...literally. 

Comment

4 Easy Ways to Improve Your Medical Coding Quality

Comment

4 Easy Ways to Improve Your Medical Coding Quality

Worried you might have a problem with your coding or your coding staff? Curious about how you can improve? We have four simple steps so you can feel more confident that you are staying on top of your coding accuracy.

Comment

Comment

ADM Reconstruction Medical Policy Changes - Dermacell

Big changes to Acellular Dermal Matrix (ADM) Medical Policies!

As an aside - we are not affiliated with, making any recommendations regarding, or suggesting superiority of brands in any way.

For a long time, Alloderm has been the only allowed ADM.  Other venders and brands have been considered "experimental."  Dermacell, another prevalent brand in the marketplace, has recently broken through the med pol end here and gotten approved as medically necessary with the majority of the major payers.

Why does this matter?

Many providers often use non-approved or "experimental" brands in surgery.  These brands may be equivalent or beyond in terms of real world efficacy, but medical policy updates move slow.  If a surgeon utilizes an "experimental" substance, it may be paid because the reviewers don't catch it or don't even ask for records.  The risk here is massive.  Hospitals are often unforgiving in their billing of patients and that is exactly where the bill tends to land so be careful!

What if the brand I like isn't approved?

Our stock response is don't risk it without backing from the vender to cover the cost.  The medical policy being dated or wrong isn't going to change things.  Feel free to work with the vender on pushing for approval if you would like to help, but until the substance is approved, don't risk it.

We have a few other tips and tricks too so feel free to reach out for further info!  Feel free to call me directly! 

 

John Gwin

Founding Partner

708.669.9313

jgwin@theauctusgroup.net

 

Which insurance companies are covering Dermacell?

Aetna – Medical Policy: Breast Reconstructive Surgery, Policy # 0185: http://www.aetna.com/cpb/medical/data/100_199/0185.html

Cigna – Medical Coverage Policy: Breast Reconstruction Following Mastectomy and Lumpectomy, Policy # 0178: https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0178_coveragepositioncriteria_breast_reconstruction_follow_mast_lump.pdf

UnitedHealthcare – Medical Policy: Breast Reconstruction Post Mastectomy, Policy #CDG.003.09: https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/breast-reconstruction-post-mastectomy.pdf

Anthem – Medical Policy: Allogeneic, Xenographic, Synthetic and Composite Products for Wound Healing and Soft Tissue Grafting. Policy # SURG.00011:https://www.anthem.com/medicalpolicies/policies/mp_pw_a053309.htm

Press Releases:

LifeNet Health Press Release regarding Dermacell coverage, Anthem: https://www.prnewswire.com/news-releases/lifenet-healths-dermacell-acellular-dermal-matrix-receives-anthem-coverage-300603527.html

LifeNet Health Press Release regarding Dermacell coverage, Cigna: http://www.prnewswire.com/news-releases/dermacell-receives-coverage-from-cigna-300411026.html

 

Practice Management Services

shutterstock_138366968.jpg

Billing

Accounts receivable, contracting & credentialing.

Bookkeeping

Credit card processing, small business loans & vendor management.

Consulting

Process workflow, procedures & protocol, staffing & training.

 
 
auctus-group-logomark-RGB-3125-01 (1).png

Simplify Your Practice

Ease the workload. Increase your bottom line.

Comment

Comment

Modifier 25 Reduction for Same Day Services Rolled Back

A very significant step in the pushback against the trend of slicing into physician revenue by insurance carriers was taken this month as Anthem rescinded its January 1, 2018 policy for same day services.  Previously the policy intended to reduce E/M reimbursement by 50% when rendered on the same day as qualifying procedures.  After a push by physicians, this policy has been rolled back to March 1, 2018 and from 50% to 25%.  Continued efforts by physicians and the AMA will hopefully put a complete stop to the policy altogether, but that is left to be seen.

AMA Article link below here...

https://wire.ama-assn.org/practice-management/win-doctors-anthem-rescinds-pay-cut-same-day-services

Comment