Author Archives: Ray J.
So another day and another batch of denials received in billing. Yet again, most of the denials are due to patients’ insurance being inactive (patient ineligible), demographic errors (e.g., address, DOB, etc.), coding inconsistencies (e.g., ICD not establishing medical necessity), … Continue reading
All CHCs struggle to balance the provision of unmitigated access to under- or un-insured patients while maintaining the fiscal solvency of the organization. PMG has discussed for more than a decade the critical need to discern between an inability to … Continue reading
By this time, most CHCs have a compliance plan. Maybe it’s not the plan you dreamt of when you started but you have something in place nonetheless. One aspect of an “effective” compliance plan that does not receive perhaps enough … Continue reading
Another year and another change with most recently updated Federal Poverty Level (FPL) guidelines. It’s not so much that the guidelines have been updated as it happens every year. What is really challenging is implementing the guidelines AND enforcing… wait, … Continue reading
Without a doubt, there are few CHC topics which seem to generate as much confusion as the use of “locum tenens.” By definition, locum tenens is used to define a provider who temporarily fills in for a vacancy, vacation, or … Continue reading
Anyone familiar with CHC healthcare knows the front desk is a pivotal place. From patient reception to scheduling to phone calls to eligibility verification to patient placement… the list goes on. A significant risk area, and one that gets too … Continue reading
Breaking News as of Dec 27th!!! So the plan to implement a 1% raise was not approved and instead Congress passed a two month 0% Medicare rate increase for Jan and Feb of the coming year. In theory this might … Continue reading
So another new year and another delay in Medicare Part B adjudicating fee-for-service (FFS) claims. In fact, to make your life easier Medicare Part B will once again hold your claims for ten days to allow the US Congress to … Continue reading
How much do you make per visit? Seems simple. Next… how much does it cost you to see a patient? Hopefully less than you make. So much is made of KPI but in the end taking a look at something … Continue reading
CHC Charges… something as simple as being sure to charge enough so as to allow payers to give you as much money as possible. After nearly fifteen years teaching revenue cycle, I’m still amazed to find CHCs who leave money … Continue reading
