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My Blog

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Holiday Joke of the Day

Posted on 18 December, 2012 at 13:25 Comments comments ()
Just before Christmas, there was an honest politician, a kind lawyer,  and Santa Claus travelling in an elevator of a very classy hotel. Just before the doors opened, they all noticed a $100 bill lying on the floor. Which one picked it up?

Santa, of course, the other two don't exist! :0)

Joke of the Day

Posted on 13 November, 2012 at 20:01 Comments comments ()
Dear Miss Managed Care,

Our HMO has recently expanded its coverage. We now continue to provide care (and bill) our dead subscribers. These subscribers have a very low rate of complaints about our services. However, they have a tendency to be stiff-necked, and unresponsive to repeated calls from our care managers. What is the proper way for our care managers to deal with this new class of subscribers?
                                                                                Sincerely, 
                                                                                Gentle Reader


Dear Gentle Reader,

It appears that you are unaware of the correct way to address these individuals or the polite way to interact with them. Refer to them as "vitally challenged", and please avoid the outmoded, derogatory term, "dead." As for their verbal "unresponsiveness," Miss Managed Care would suggest that your care managers be empathetic and simply write down what you imagine they would say or feel. You have ample practice using this technique with your living subscribers. Miss Managed Care commends your attempts to broaden your understanding of this vast undeserved population. 

                                                                                  Best Regards,
                                                                                  Miss Managed Care

Joke of the Day

Posted on 8 October, 2012 at 20:12 Comments comments ()
Poor old lady...

This old lady walks into the Doctor's office and says, "Doctor, please help me. I have a terrible problem with farting. It's not really a social problem, because you can't smell it or hear it, but I must have farted 20 times since talking to you." The Doctor nods his head and says, "Take this bottle of pills and use them all. When they are all gone in about 2 weeks, come back to see me." The old lady comes back 2 weeks later and is angry. She says "What was in those pills? I fart just as much. You still can't hear them, but now they smell horrible!" The Doctor again nods his head and says, "Great, that takes care of your sinus problem, now let's work on your hearing."

Why doctors should outsource their billing??

Posted on 8 October, 2012 at 20:08 Comments comments ()
  1. Billing is not a doctor's "core competency."
  2. Doctors are seeing more patients and need their staff to help them in seeing and processing the patients.
  3. Doctors have trouble collecting money from patients and insurance companies. 
  4. Doctors waste a lot of time and money doing their billing "in-house."
  5. Claims processed in-house do not get submitted in a timely manner.
  6. Doctors (and their staff) do not have time to resubmit rejected claims.
  7. Large numbers of claims are rejected due to staff errors or outdated software.
  8. Doctors lose rightful income due to under-coding their visits.
  9. Doctors spend a lot of money on staff training and benefits.
  10. Server-based software constantly needs updating.
  11. Doctors are concerned about Medicare audits.
  12. Doctors are confused about the new healthcare legislation and how to qualify for the stimulus money available from the government.
  13. Doctors offices are drowning in paperwork. 

For more information on how Shore Physician Solutions, LLC can help your practice with any of the above listed items, please contact us at 732-678-5884 or [email protected]. 

Time For a Change??

Posted on 15 July, 2012 at 18:22 Comments comments ()
As a practicing physician, your workload is already substantial. Add to that, the responsibility of billing for your services which may also require your constant attention to instituting, upgrading, and perfecting the billing process. Not to mention keeping up eith current and new medical coding requirements and finding ways to stay compliant with the HIPAA privacy and security standards. Trying to accomplish all of this without completely disrupting your office or having to recreate most of your processes can be a daunting task.
 
Statistically, 30% of all medical practices' income is lost due to improper coding, under-pricing, missed charges, or denied claim. That's right, you could be losing our on 25% or higher of billable dollars annually, due to simple medical billing errors.
 
IS YOUR PRACTICE AMONG THOSE OFFICES RECEIVING 70% OR LESS OF THE AVAILABLE MEDICAL BILLING REVENUE DUE TO THEM?
 
Our job, at Shore Physician Solutions, LLC, is to get you the highest reimbursement that you deserve. Accurate billing is extremely important to your success. Not only do we understand this, but we make it OUR BUSINESS to be successful in chieving these results for you.
 
Contact our office for more information on how our medical billing & practice management company can benefit your practice at (732) 678-5884 or [email protected].

Joke of the Day

Posted on 28 June, 2012 at 6:51 Comments comments ()
Doctor’s Contributions
Doctors were told to contribute to the construction of a new wing at the hospital.
What did they do?
 
The allergists voted to scratch it.
The dermatologists preferred no rash moves.
The gastroenterologists had a gut feeling about it.
The neurologists thought the administration had a lot ofnerve.
The obstetricians stated they were laboring under amisconception.
The ophthalmologists considered the idea short‐sighted.
The orthopedists issued a joint resolution.
The pathologists yelled, “over my dead body!”
The pediatricians said, “grow up.”
The proctologists said, “we are in arrears.”
The psychiatrists thought it was madness.
The surgeons decided to wash their hands of the whole thing.
The radiologists could see right through it.
The internists thought it was a hard pill to swallow.
The plastic surgeons said, “this puts a whole new face on thematter.”
The podiatrists thought it was a big step forward.
The urologists felt the scheme wouldn’t hold water.
The cardiologists didn’t have the heart to say no.

Joke of the Day

Posted on 19 June, 2012 at 8:52 Comments comments ()
Doug was removing some engine valves from a car on the lift when he spotted the famous heart surgeon, Dr. John Lee, who was standing off to the side, waiting for the service manager.
 
Doug, who was somewehat of a loud mouth, shouted across the garage, "Hey Lee. Is dat you? Come over here a minute."
 
The famous surgeon, a bit surprised, walked over to where Doug was working on the car. Doug, in a loud voice that all could hear, said argumentatively, "So. Mr. Fancy Doctor, look at this work. I too, take valves out, grind 'em, put in new parts, and when I'm finished, this baby will purr like a kitten. So how come you get the big bucks, when you and me are basically doing the same work?"
 
Dr. Lee, very embarrassed, shook his head and replied in a soft voice, " Try doing your work with the engine running."

Don't Keep Your Practice Hanging By Not Collecting Copays & Deductibles At The Front Desk!

Posted on 18 June, 2012 at 20:08 Comments comments ()
Your medical practice cannot afford to allow patients to be billed for their copayments and deductibles.
 
Did you know it is illegal to routinely waive deductibles and copayment amounts? Most insurance carriers do not tolerate this practice because it is a breach of contract. They may view it as giving a patient a discount and making the insurance company pay 100% of the fee. If audited, the federal government can assess penalties for not colelcting deductible payments for patients see with Medicare benefits.
 
However, if deductible or copayments are waived for legitimate reasons on a case-by-case basis, and documentation stating the reason for the waiver appears in the patient's file, there should not be any problems. Deductibles and copayments should be collected at the time of service, and copayments should definitely be collected prior to being seen by the physician.
 
When making the appointment with the patient, it is essential to get the patient's health insurance information. At the time of scheduling, the scheduler should remind the patient that all copayments and deductibles are due at the time of service. Before the patient sees the physician, the front office should say "Mr. Smith, as you know your plan requires a copayment of $xx.xx or x%. How would you like to pay?"
 
One to two days prior to the patients' appointment, reminder calls should be made. The reminder should include: the date and time of the appointment, plus any copayment and/or deductibles due at the time of service. Most office visit copayments are too small to merit sending out statements. This is a very costly method of collection, especially if the patient refuse to respond or remit payment and numerous statements are sent. It is best to make every effort to collect copayments and deductibles at the time of service plus reserve sending follow-up statements (via mail) for any patient responsibility stated on the Explanation of Benefit (EOB).
 
If your practice is not already set-up, consider offering credit card payments to your patients (i.e., Visa, MasterCard, Amex, and Discover).

Advantages of Outsourcing Your Medical Billing

Posted on 23 August, 2011 at 12:21 Comments comments ()
Outsourcing has become a very common practice when it comes to medical billing, in today's society.
 
Many practices will find there are many advantages to this industry shift. The concept is not new; outsourcing has been a popular way of conducting business for quite some time. Consider it an economic advantage. In medical billing, outsourcing allows for reduction in computer and software costs that would be present if a company were to retain this task. The average computer needed to run these types of programs would be close to $1000, if not more. The software, though not costly in itself, often requires licenses for each user at about $100 for each user, sometimes more. Add in the cost of electricity for running the equipment, salary or wages (plus benefits and vacation time) for the worker, a space to have them work in, etc. All these factors add up to money that can be better spent on other needs of the business and time that can be better spent with patients rather than paperwork. Outsourcing your medical billing can provide the freedom to do this.
 
Medical billing has many regulatory restrictions that are applied due to HIPAA laws, the Fair Credit Reporting Act, and several other agency restrictions. By outsourcing your medical billing, the burden is shifted from the hospital or medical office to medical billing company. Again, this is an economic advantage, as there is no cost for the medical office to train a professional to learn and keep up with all the regulatory requirements of medical billing and collections. Another advantage to outsourcing medical billing is that by sending the work elsewhere to be done, postage and phone costs are reduced significantly. For every dollar saved in administrative costs, that much more can be placed to things that will improve the business. It could be the purchase of new or advanced technologies, or perhaps the hiring of a specialized doctor.
 
In conclusion, outsourcing your medical billing saves more energy and effort by medical staff that can be spent on servicing the patient and providing an elevated level of care and concern. This will provide a better image of the medical facility and in turn, help to increase revenue and return business to that facility. It is a win for the medical offices and a win for the patients they serve.  The possibilities are endless.
 
For more information on how Shore Physician Solutions, LLC can assist your practice in this economic advantage, please contact us at (732) 678-5884 or [email protected].

Preparing for the ICD-10 Transition

Posted on 19 July, 2011 at 10:45 Comments comments ()
smllBox ICDReady, ICD-10 ReadyMedical practices face two significant deadlines that require planning and testing in 2011. The first deadline, January 1, 2012, is for the adoption of a new standard — the 5010 standard —for electronic claims transactions. This change must be made to accommodate regulatory changes in core billing processes such as claims submission and remission, claim status inquiry, eligibility inquiry, and transaction acknowledgment. The second deadline is the long-awaited (or long-dreaded) deadline for moving from the ICD-9 to the ICD-10 code set. This deadline is slated for October 1, 2013. In addition to changes physicians and other providers will have to make in recording diagnoses and procedures, the move to ICD-10 will require extensive re-programming and testing of practice management systems, revision of encounter and testing forms, and numerous other changes.It is critical that practices be ready for these two deadlines. Failure to prepare for either could bring a practice to its operational — and financial — knees. The following is an overview of these two transitions provided by CMS.
 
About the Version 5010 Transition on January 1, 2012
On January 1, 2012, standards for electronic health care transactions change from Version 4010/4010A1 to Version 5010. These electronic health care transactions include functions like claims, eligibility inquiries, and remittance advices.  Unlike the current Version 4010/4010A1, Version 5010 accommodates the ICD-10 codes, and must be in place first before the changeover to ICD-10. The Version 5010 change occurs well before the ICD-10 implementation date to allow adequate Version 5010 testing and implementation time. If providers do not conduct electronic health transactions using Version 5010 as of January 1, 2012, delays in claim reimbursement may result. If health plans cannot accept Version 5010 transactions from providers, they may experience a large increase in provider customer service inquiries affecting their operations.Preparing for ICD-10 and Version 5010 – including potential updated software installation, staff training, changes to business operations and workflows, internal and external testing, reprinting of manuals and other materials, and more – will take time.
 
About the ICD-10 Transition on October 1, 2013
ICD-10 codes must be used on all HIPAA transactions, including outpatient claims with dates of service, and inpatient claims with dates of discharge on and after October 1, 2013. Otherwise, your claims and other transactions may be rejected, and you will need to resubmit them with the ICD-10 codes. This could result in delays and may impact your reimbursements, so it is important to start now to prepare for the changeover to ICD-10 codes.This change does not affect CPT coding for outpatient procedures.
 

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