Trailblazer and Medicare Part Ways
TrailBlazer Health Enterprises' attempt to remain the Medicare administrative contractor for Texas failed in March 2012 when the Government Accountability Office denied its appeal of the selection of another vendor. This decision by CMS was a part of its effort to reduce administrators from 15 to 10 by the 2016 deadline. Claims will now be processed by Novitas Solutions,… Read More
iPads Improve Efficiency
March 20, 2012 By Marty Briggs A recent study, published in the Archives of Internal Medicine, tracked the Apple® iPad® usage of 115 residents of internal medicine at the University of Chicago who were given the device to use during their rounds. The study found that the addition of the iPads helped residents to be more efficient at ordering tests and procedures for their patients.… Read More
Arbitrage in Healthcare
Through years of development in the world of finance, there are applicable lessons to be gleaned for any market. The changes of the aggregate across all markets is showing an information problem. The problem of hidden information leads to market inefficiencies. Market inefficiencies expose us to the opportunity for arbitrage, and although these concepts have been mainly relegated to places… Read More
Case Study: Coding with the Right Code
By Matthew Moreno, VP of Revenue Cycle Management We at Exemplar Health Resources see a lot of things come up in our clinics as we aim to achieve optimal collections for medical services rendered. At times we notice trends and want to share those with our website visitors. One recent case we finished was with a physician practice using the wrong code for a new procedure introduced to their… Read More
Accountable Care Organization Final Rule
By Matthew Moreno, VP of Revenue Cycle Management The Centers for Medicare and Medicaid (CMS) under the Department of Health and Human Serivces, have issued their final rule documentation of which over 600 pages delineates the rules whereby physicians and other healthcare providers can unite for the quality care of Medicare beneficiaries. Exemplar Health Resources has the opportunity to sift… Read More
5010 Is Your Practice Ready?
On January 1, 2012, the health care industry will be required to conduct the current HIPAA electronic transactions, including claims submission, remittance advice, eligibility, claims status, referral authorizations, and others, using the upgraded 5010 version. Preparation for the switch and the subsequent cash-flow impact starting in 2012 is essential. This resource is an overview to… Read More
Physician Practice Management Case Study
Overview Well-established practice in the area with the lead physician also serving as professor at local medical school and regional research hospital. The practice had 2 physician providers at the time of the initial consultation, and delivered complex treatments specializing in primary immune deficiency. The purpose of this case study is to demonstrate the effective ways we manage practices… Read More
Cost of Practicing Medicine
With the release of the MGMA 2011 Evolving Healthcare Environment Status and Readiness Report, we put together a brief summary of the current layout of costs within private practices. Along with data on the current position most practices have, we make a few recommendations to reduce costs in the age of the Affordable Care Act.
Cost of Practicing Medicine (PDF) Read More
Increase Revenue - Lower Costs
61% of physicians reported managing their own billing is a 'considerable or extreme challenge' In 2012, reimbursements will be cut dramatically by Medicare, with MGMA predicting up to 29% in lower physician payments. This measure is fueled to accommodate the much maligned sustainable growth rate (SGR). The SGR began in 1997 to slow the expansion of Medicare spending, but with Medicare’s greatest… Read More