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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