What are RVUs and how do RVUs impact Payment to Medical Practices?

A challenge in the US Healthcare system is that there are patients that seek care, providers/physicians that want to provide quality care and receive appropriate payments for helping patients with their care and payers that establish the payment rules and want to minimize payments to providers.   Payers include commercial payers (e.g. Aetna, Cigna, United, Blue…

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The Tricky Game of Payer Edits to Deny Insurance Payments to Providers

Medical billing needs to be completed for each medical practice and the revenue cycle management process requires training, specialized skills, time and focus. Most physicians and office managers have multiple duties per day to manage that provide higher value to their practice than chasing down medical claims. High value activities for Medical Offices include strong…

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Independent Provider Practices Provide Cost-Effective Healthcare

Since aspects of the HITECH act started in 2009, the US Healthcare system experienced significant consolidation of independent medical practices into the Hospital Systems and/or Integrated Delivery Networks (IDNs).   The incentives for our Healthcare system promote large IDNs.  Once a practice system obtains a certain size, the system leverages their negotiation power to obtain higher…

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ICD10 – One Year Later

It is hard to believe that it has been over one year since the United States medical system migrated from ICD9 to ICD10 Diagnosis codes.  On October 1st, 2015, the new standard for diagnosis codes, ICD10, was implemented in E.H.R. systems, Medical Billing Systems, Practice Management Systems, Clearing houses and Insurance Companies.    Physician Offices and…

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Why a 99% Collection Rate is More Important to Independent Physician Practices compared to Hospital-Owned Medical Practices

The revenue cycle (more commonly known as medical billing) is a complicated and important aspect of any Medical practice.   Patients rely on Health Insurance to pay for some of the cost of Health care.   Although most patients have health insurance few understand the details of their policy.   Health insurance plans have a range of coverages…

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