PMG Insights Blog
Don’t Let Coding Errors Cost Your CHC Cash – “Decoding” Code Linkage and Medical Necessity
Without a doubt provider coding errors are a top reason for rejected claims at Community Health Centers (CHCs). This shouldn’t be surprising. We all ...Read More
E&M Code Level Consolidation On the Table… Again
Contributed by Ray Jorgensen Back in 1996 when I became the first CPC in RI and one of only seventeen in New England, we were ...Read More
Tactics to Boost CHC Front Desk Performance (and Your Bottom Line)
Your Community Health Center (CHC) front desk has many roles. It serves as a welcome face for those in need of care and must ...Read More
Choosing a CHC Provider Enrollment Vendor – Four Valuable Tips
Community Health Centers (CHCs) often struggle with credentialing and provider enrollment. Trying to keep the process in-house means finding (and keeping) experienced staff. Too ...Read More
Delegation and the CHC Revenue Cycle – Successful Leaders Set it and Forget it
The devil is in the details, and that is doubly true when it comes to the Community Health Center (CHC) revenue cycle. This complex ...Read More
Bigger than Billing… Exploring the Nuances of True Revenue Cycle Management
When we tell people that PMG offers Revenue Cycle Management services to Community Health Centers (CHCs), many people assume that we created a fancy ...Read More
Mission vs. Survival – The Community Health Center Battle
For the past several months, Community Health Centers (CHCs) have been faced with the uncertainty around continued funding by the federal government; funding which ...Read More
Provider Enrollment & Credentialing: Solving Enrollment Issues
We at PMG have never seen an FQHC that is not working tirelessly to obtain maximum reimbursement. You found the right staff, you finally ...Read More
Co-Sourcing Your CHC Billing Department – Have Your Revenue Cake and Keep Your Staff Too
Making the move to an outside vendor for your community health center’s (CHC’s) billing needs can be a difficult decision. CHCs are truly the ...Read More
Secrets for Winning the A/R Battle at Your CHC
At month’s close, Community Health Center (CHC) executives across the country brace themselves as they review the status of their accounts receivable (AR). Dollars ...Read More
Enrollment vs. Credentialing vs. Facility Privileges
To many in CHC leadership, these three topics can be confusing. To maximize reimbursement, while staying compliant with governmental regulations and payer contractual language, ...Read More
How the ACA Could Affect Your CHC
Congressional consternation continues in Washington D.C. Too many options from too many interest groups makes it difficult to find commonality to meet the needs ...Read More
Locum Tenens vs. “Incident to” Billing: Unraveling the Mystery
Too many CHCs are befuddled when it comes to understanding how to bill services under another provider’s National Provider Identifier (NPI). Some CHCs do ...Read More
PMG’s FQHC Funding Predictions for 2017
2016 was tumultuous to say the least, with the most divisive U.S. election in modern history topping the list. Despite the dire predictions of ...Read More
Top 5 Reasons PPS G Codes Need Code Expansion
Coding is a complex topic. So confusing is it that too many in CHC leadership fail to sometimes grasp nuances essential to broadly capturing ...Read More
CHC Credentialing… Great Opportunities and Frightening Liabilities
Many CHCs struggle to maximize reimbursement. Transition from cost based to PPS rates, understanding Medicare G codes, ACA programs advocating APM and expansion of ...Read More
What Does EDI Mean for Medical Billing?
I was asked to write a blog post about what I do as the Director of EDI and Business Systems at PMG. If you ...Read More
Improving Self-Pay is Not One Size Fits All for CHC’s
Is your self-pay AR continuing to grow and you just don’t know what to do about it? You are not alone. Many of our ...Read More
Gross vs Net Collections: What Your CHC Needs to Know
At PMG, we encourage our community health center (CHC) clients to familiarize themselves with their financial numbers and to utilize the data reports we ...Read More
Claims Denial Reasons and How to Fix It
Are you in denial? Denials are claims that get processed by a payer but are not paid as expected. ‘Denial’ is a word that ...Read More
Culture of Confidentiality Part II
Your Health Center’s biggest information security threat is… your employees? Information Security Professionals are constantly on the watch for new threats. Technologists deliver strong ...Read More
Revenue Cycle Numbers: Day in Accounts Receivable (DAR)
A Key Performance Indicator (KPI), simply put, is a performance measurement. KPIs evaluate the success of a particular activity, in this case, the success ...Read More
How Medical Coding Training Could Help
CHC providers are notoriously bad at coding. Don’t believe me. Look at the data. CMS limited payment of multiple encounter rate payments at CHCs ...Read More
Numbers Don’t Lie: FQHC Key Performance Indicators
Reimbursement in the community health center (CHC) world has changed drastically over the program’s last 40 years. Gone are the grant dependent entities of ...Read More
Medicare PPS – are we having fun yet?
The Transition to PPS Payment Methodology The transition to the PPS payment methodology for Medicare has not been as seamless as some would’ve thought. ...Read More
What’s Your Average Number of Visits Per Hour?
Let’s face it. There are very few things that your CHC can do to immediately and profoundly increase income. Sadly you can’t magically increase ...Read More
Charge Setting at your CHC…Maximize Opportunities with Prudent Planning
New HRSA SFDS PIN, Medicare Rate Hike, & Medicare “G” Codes Create Perfect Storm Too often when we ask a CHC CEO or CFO about ...Read More
Elements of an Effective Payment Plan
Whether it’s the complexities in payment methodology, increase focus on outcomes, or the attention on health information technology, there is another common challenge among ...Read More
Time has not been wasted.
So everyone is really, and I mean really tired of hearing about ICD 10, and the latest onslaught of daily emails all addressing new ...Read More
Why Are We Scared of Auditors?
Want a sure fire way to send shivers up anyone’s back? Just tell them that they are going to be audited. Audit is a ...Read More
Find Inspiration in Constant Change…Or at least a reason to be willing to constantly change.
I write as I am crusing, according to our pilot, at 37,000 feet heading to Phoenix for work at the Region IX conference. Most ...Read More
Time for Spring Cleaning!
Time for Spring Cleaning! Here in New England the weather has started to warm up. It will be close to 60 today which for ...Read More
Adapting to Change
Groups like the American Medical Association which lobbied hard for another ICD-10 delay had their wish granted on Monday evening. The healthcare industry anxiously ...Read More
ICD-10 Delay… Again. Team Ready v. Team Tardy.
By now you have most likely heard about the probable delay of ICD-10, again. H.R. 4302-Protecting Access to Medicare was passed by the House ...Read More
The ground is rumbling in Washington.
Well it’s been an interesting week in Washington. On Thursday, the U.S. House of Representatives voted to approve H.R. 4302-Protecting Access to Medicare  ...Read More
ACA & ICD-10 Success… Make Your Own Luck.
“Be prepared, work hard, and hope for a little luck. Recognize that the harder you work and the better prepared you are, the more ...Read More
Benchmarking for Payment Expectations
Recently I was challenged by a CFO who was caught off guard when payments were significantly lower than expected. After a slow couple of ...Read More