Tag: money

The 4 Most Common Reasons Your Practice’s Claims Are Bouncing

Posted on by VettersEnt

Billing can be time-consuming, tedious and frustrating to say the least. It can be even more frustrating when the medical claims that you worked so hard to submit are bounced right back. What are the most common reasons that a medical practice’s claims are bouncing back after submission?

Minor Errors

Just like it’s easy to miss a comma in an email or mistype a word, it’s also very easy to make minor errors in medical claims. Reimbursements are often denied or delayed due to seemingly-small mistakes, like forgetting to include a plan ID number or mixing up a letter. Because front desks are already so busy and overwhelmed, mistakes can fall through the cracks. One winning solution to this is using a professional outsourced claims processing service that will review claims before submission and look just for errors. The time saved from going through a resubmission is much less than time spent reviewing claims.

Missing Information

Another common reason that claims are bouncing is insufficient information. You always need to submit documentation to back up claims, and you should always supply each insurance provider the information that is requested to process payment in an expedient manner. Again, it is much easier to put the effort into properly gathering everything beforehand instead of needing to go back in the future to find the right documentation.

Skipping Authorization

If you needed authorization before a procedure was performed and it was not secured, you shouldn’t be too surprised that a claim bounced back your way. You should verify whether or not prior authorization is needed before you schedule the procedure. When it is time to bill, ensure that you also include the prior authorization number on the submitted claim. While prior authorizations can seem like an annoying extra step, they are vital to ensuring that claims receive approval in a prompt manner.

Changes on the Patient End

One of the most common reasons for claim denial isn’t necessarily your practice’s fault at all. Claims are often denied because a patient’s coverage has changed, the plan or payer has been changed or coverage has been terminated altogether. Even if you think everything is the same as the last time you spoke with a patient, you should always ask to confirm insurance information and see an insurance card at each appointment.

Trust the Experts at Vetters Enterprises for your Billing Needs

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

How Can Volunteering Help Your Physicians Recharge?

Posted on by VettersEnt

Experts have known for a long time that volunteering is a good thing. After all, what could be bad about giving back to the communities around us? However, new research is suggesting that volunteering is also good for your body and mind. Physicians who are looking to recharge and reignite their passion for helping others can benefit from taking time to volunteer.

The Mental Health Benefits

Volunteering has a wonderful effect on mental health. According to the Corporation for National and Community Service, much of that stems from social integration theory. Social integration theory is the idea that the social connections between individuals provide meaning and purpose and satisfaction. Individuals who volunteer feel accomplishment from giving back and also gain fulfillment from being in a helpful role. Another study of older adults found that volunteering can buffer the sense of loss that they felt as they lost other identities, like being a wage-earner or parent.

The Physical Health Benefits

One study from Carnegie Mellon University found that adults over the age of 50 who regularly volunteered had a lower likelihood of developing high blood pressure. As most physicians know, high blood pressure is a major risk factor for heart disease, stroke and premature death. While the link between physical health and volunteering might be incidental, it goes to show that doing good can also do your body a whole lot of good.

Why Volunteering for Physicians?

Long days and nights at a medical practice can make it easy to forget why doctors went into medicine in the first place—to help others. If doctors and nurses in your practice need to recharge, volunteering is the perfect way to do so. What are some of the other benefits of volunteering?

  • Increase social interactions with people other than patients and co-workers during the week.
  • Provide a sense of satisfaction and increase self-esteem.
  • Add career experience in other fields to your resume, like public speaking, writing or business development.
  • Stay mentally and physically active outside of work.
  • Enjoy the rush of endorphins and happy feelings associated with volunteering (similar to how you feel after a great workout).

Partner with Vetters Enterprises for Help Taking Your Practice to the Next Level

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Is Your Practice Location Hurting Your Bottom Line?

Posted on by VettersEnt

What is one of the keys to a successful medical practice? It’s all about location, location, location! When you are trying to find the perfect practice location for your office, there are many factors that you must consider to ensure long-term profitability and success. Whether you’ve been in the same location for a decade or are finding space for the first time, here’s what you need to know about choosing the right location. 

Why Does Location Matter?

Three recent studies found a single common factor in what matters to patients—location. 6 out of 10 patients choose a practice primarily based on location. In fact, convenient location is twice as important to patients as your practice’s success rates or outcomes.

Competition Isn’t Always a Bad Thing

In neighborhoods and cities where medical practices are on every street, it might seem like you have no chance to succeed against already-established doctors with a reputation in the community. Don’t be intimidated by competition, as there are many clever ways to differentiate your practice from the crowd. Check the population-to-professional ratio for the area around you. In areas with low numbers of professionals, there won’t be much competition. However, in busy areas marketing, reputation and customer service can make a huge difference.

Demographics Make the Difference

Another key to a great practice location is staying on top of ever-changing demographics. Is the population declining or growing? In many cases, it’s easiest to gain traction in newer communities than tight, well-established locales. Pay attention to numerous demographics including household income averages, age distribution, the types of jobs and population growth.

Look Around You

The most successful practice locations are often those surrounded by other popular things. What else is located within 5 miles of your potential practice location? Are there banks or grocery stores? What traffic patterns are there? In general, a location that is passed by 40,000 or more cars in a 24-hour period is considered to be a retail location. If you set up shop in a smaller town, you might have higher visibility thanks to less roadside clutter, but you also won’t have access to as many potential patients.

Partner with Vetters Enterprises for a Great Practice Location

Vetters Enterprises specializes in practice management, private practice business support and revenue cycle optimization. We can perform in-depth assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Patient Payments Simplified

Posted on by VettersEnt

Most practitioners don’t know that you are 50% less likely to recoup a patient copay if they leave your office without paying.  This impacts your cash flow more than you know.

I wanted to share with you a great idea from a great company – Payspan.  Some folks who work with Medical Assistance or any of the Beacon Health Options carriers may be very familiar with logging on to Payspan to pick up their EOPs but they have a great program for helping you get that payment up front that you need.  Check out this webinar if you can.

 

Webinar: Simple Techniques for Accelerating Patient Payments

Join us Thursday, October 6th for the Simple Techniques for Accelerating Patient Payments Webinar

If you missed Simple Techniques for Accelerating Patient Payments Webinar join usOctober 6th, 2016 and let us help you accelerate patient payments.

The abundance of high-deductible health plans is presenting unique revenue challengesfor healthcare providers, and many practices are struggling to quickly and accurately collect patient financial responsibility dollars. There are simple tips and solutions every practice can adopt to increase patient revenue and improve operational efficiency.
SAVE YOUR SEAT TODAY
Please join us on Thursday, October 6, for a complimentary webinar titled, “Simple Techniques for Accelerating Patient Payments.” We will be speaking about:

  • Best practices for dealing with the increase in patient responsibility and high-deductible health plans;
  • Best practices for accelerating patient payments; and
  • Innovative patient payment solutions that will get your practice where it needs to be today.

With the shift to new reimbursement models and the increase in out-of-pocket patient responsibility, it is more important than ever for providers to adopt innovative tools in order to stay financially viable. If you are interested in maximizing revenue in today’s evolving healthcare economy, join us at 2:00pm, EDT on October 6th, 2016.

Sincerely,

The Payspan Team
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ABOUT PAYSPAN
With the largest healthcare network in the U.S., we provide payment automation services that improve administrative efficiency, meet regulatory requirements, and enable payers and providers to manage new reimbursement strategies. We bring together healthcare expertise with proven financial services technology to empower a new generation of healthcare economics. CONTACT US

 

Get on the “Road to 10”

Posted on by VettersEnt

CMS is pushing hard to get everyone prepared for 10/1/2015.  What is that date all about?  That is the drop dead date for ICD-10 conversion.  CMS says they are not pushing the date for compliance back any further and I know most of you are saying “Yeah right…that’s what they said last year”.  Well in our opinion it’s got to happen this year.  Check out CMS’ “Road to 10” website and tools.  This site has been improving and improving over time and it looks to us like they are ready to pull the trigger.

http://www.cms.gov/Medicare/Coding/ICD10/index.html

We know most of you are grudgingly preparing or angrily protesting the change but in reality this is one of the best things to happen in healthcare.  ICD-10 coding is going to really go a long way to help agencies track the healthcare that is administered in this country accurately.  Because ICD-10 coding requires the providers to be more specific about the patient’s medical condition, in the long term this can mean:

  • More funding towards specific diagnosis and treatment
  • More funding to areas of the country experiencing specific diagnosis ranges
  • Increased research into specific diagnosis
  •  Analytics and reporting to help providers in their areas

By no longer supporting the “unspecified” diagnosis codes we get a clearer picture of the country’s predisposition to certain diagnoses in specific regions of the country.  That way it won’t take someone accidentally finding that a small town in PA had less heart disease per capita than the rest of the country.  It will be through precise analytics.

http://www.huffingtonpost.com/dr-rock-positano/the-mystery-of-the-roseta_b_73260.html

The rest of the world is already using ICD-11 and it is about time America attempted to catch up.  Converting to ICD-10 is a step in the right direction.

 

 

 

Thinking of starting your own practice?

Posted on by VettersEnt

With over 70% of hospital employees getting out and getting back into private practice whether they have done it before or doing it for the first time this article has the top 5 things we recommend our providers do before starting out on their own.  They don’t teach you this in med school!

http://www.kareo.com/gettingpaid/2014/09/the-5-first-steps-to-start-a-new-medicalpractice/

Now of course we recommend outsourcing as many activities as you can, and we can help you with cost effective solutions and personal service that a national company can’t compete with.  Please consider us as a source to help you in improving your reimbursement and gaining efficiencies in your office!

ICD 10 Delayed – Again

Posted on by VettersEnt

The Centers for Medicare and Medicaid Services posted in August 2014 that the road to ICD-10 compliance will be another year longer.  The new date for conversion is 10/1/2015.  As we’ve published before, this conversion is long over due and WILL be coming at some point even if they keep pushing back the date.

This conversion was not a part of the Affordable Care Act, so if you are thinking that if the ACA goes away so will this conversion and that is just simply “head in the sand” thinking.  This is an implementation of a international coding standard and we here in the US are just behind the curve with the rest of the western world in using this new classification system.  We do need to catch up and we eventually will.  Don’t let this conversion scare you out of your practice!  I have had a lot of providers tell me that they will quit first before converting, and that just isn’t practical.  ICD-10 will benefit the medical community by increasing the accuracy of diagnosis coding and allow entitlement programs and insurance carriers to gain more specificity in tracking diagnosis populations.  With more specificity comes more attention which leads to more reimbursement for the provider.

If you are a small practice, I urge you to check out the CMS website for the “Road to 10” implementation map

Road to 10: CMS Online Tool for Small Practices

CMS has released Road to 10, an online resource built with the help of providers in small practices, is now available. This tool is intended to help small medical practices jumpstart their ICD-10 transition.

“Road to 10” includes specialty references and gives providers the capability to build ICD-10 action plans tailored for their practice needs.

Also, VE Cycle Management specializes in providing solutions that are already ICD-10 ready.  We can help!  Contact us today!

ICD-10 Delay

Posted on by VettersEnt

So on 3/31/14 both the house and senate voted on a “Dr. Fix” bill that included language for another one year delay on the ICD-10 implementation.  CMS has been saying for more than a year that there will be no more delays…period… Then what does the congress do? Overrule them.  Many healthcare organizations are speaking out that the delay portion of the bill did not have to be included. That congress has once again cost us billions of dollars by not listening to their constituency or the experts when it comes to throwing in additional pieces of legislature just to pad the bill.  Here is what the American Healthcare Information Management Association had to say: http://journal.ahima.org/2014/03/31/senate-votes-on-icd-10-delay-bill/

While most experts agree it was a stupid move to include the delay in the bill, now providers are wondering what they are supposed to do.  Check out this link: http://www.fiercehealthit.com/story/icd-10-delay-how-providers-should-respond/2014-04-02

As far as VE Cycle Management is concerned we are going to continue to prepare our clients for ICD-10 as part of what we do for them daily.  Providers now have some extra time to train, map and migrate and may think that the road to full implementation will be slowed again.  The point is and the point that my company will emphasize is “don’t put off tomorrow what you can do today!” 

ICD-10 is still coming, we are the only western nation still on ICD-9, most of Europe is on ICD-11 so it’s just a matter of time and you have to make sure your staff, technology, and you are ready for it.  Ask us, we’ll help!

The Perils of Business Ownership

Posted on by VettersEnt

Now don’t get me wrong, I love being my own boss.  This is what I have waited for all my life, I think.  When you have been raised under the poverty line you do everything you can to make sure that when you finally get to be an adult that you never dip below that line again.

Thus has been my goal throughout my life.  I think when you add children into the mix it becomes a serious goal.  Reaching my 30s-40s it seemed like the stuff I had gave me status in my mind.  I had a house, garage, 2 cars, a kid, nice stuff.  I must have made it somehow.  Certainly better than my parents did, I thought, in my mind.  As I am moving out of my 40s and soon into the big 5-0 I realized that I had it all wrong.  As a person with an innate entrepreneurial spirit, you are always wanting more, and it isn’t more stuff.  That isn’t what does it.  It’s more meaning and purpose in your life that turns the motor on.  I realized this when I buried my parents 7 months and 10 days apart.  All their stuff, their memories, prized possessions now became scrutinized by everyone and their purpose in life became increasingly more obscured.  What were they here for.  Surely this pile of old clothes and pots and pans didn’t tell that story.

So I began my journey into business ownership because I wanted my purpose in life to be more important than what the money from a “job” got me.  Oh I won’t lie, when the business isn’t doing well all I am thinking about is what am I going to have to give up or what am I going to lose, my house, my car, all of it.  But yet I still get up and I still try and find new ways to get my business name and purpose out there, I’m not giving up the spirit that drives me, that innate entrepreneurial spirit that has taken hold of me and made me the mad woman I am today.

I love running the show, I love being my own boss, I love what I do for the first time.  Is it scary…HELL TO THE YEAH!  But it’s my rules, my vision, my choice.  I’ve got some great support and one hell of a marketing director and we are going to make it.  And for the first time in decades my back brain is not saying “you should be doing something else, this isn’t you”.  You don’t know how long I have wanted to quiet that voice.  I think he’s finally speechless for a while.