Practice Management
Monte Sandler Insurance plans are scrutinizing claims more than ever before. Common questions from our clients are: What does this mean? What should I do? Should I be worried? Generally, there are three types of payer reviews: prepayment, postpayment, and probe. The first step is to figure out what type of review it is. What you do and how you handle the review is dependent on that information. Should you be concerned? Always. Payer reviews …
Read MoreThe urgent care industry is in its fifth decade and still growing! The driving forces of affordability and accessibility continue to fuel this growth. Success has been propelled by the agility of urgent care operators in adjusting their business model to meet the demands of their communities. Initially, urgent care centers were a welcome supplement in communities where the emergency department was the only option for medical care apart from PCPs or specialist offices. Roughly …
Read MoreA wise person once said, “If a claim is rejected or denied, the energy to get it paid is five times the energy if it went through as a clean claim.” Maybe it is only four times or three times the work, but the point is that we should all do everything we can to avoid rejections and denials! Unlike more complicated specialties subject to complicated coding, authorization, and other factors, in an urgent care …
Read MoreWhen it comes to measuring your financial performance, metrics translate the actions of others into insight. They provide visibility into the efficacy of your overall billing process. But while they may shine a light on where you need to improve, they don’t tell you how to do it. For a better understanding of how well your clinic is optimizing the billing process, look at your everyday practices. Our revenue cycle management (RCM) experts compiled 10 …
Read MoreThe Protecting Medicare and American Farmers from Sequester Cuts Act was signed into law on December 10, 2021. This law addresses the reduction in the 2022 Conversion Factor set by the Physician Final Rule, as reported in my December column, increasing the 2022 Conversion Factor by 3%. The new conversion factor becomes $34.61 compared to $34.89 in 2021. With the increase in Relative Value Units on most E/M codes, the impact to 2022 rates becomes …
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