Track Variances in Billed Charges
Today's BIG Idea comes from data analysis projects I do for healthcare consultants. This consultant is working with a group that outsourced their billing and then had revenue cycle challenges. Today's podcast describes an unusual challenge -- the billing company was...
Find Missing and Expired Authorizations
Today's BIG Idea is from a practice in the Midwest who had a payer deny a claim because the pre-authorization was for one day and the day of the procedure moved. Are pre-authorizations giving your practice headaches, too? Listen for ideas from both AthenaPractice...
Find Incident To Billing Opportunities
Are you tired of seeing payments reduced due to advanced practitioners and incident to billing rules? You are not alone. Today's BIG Idea is from a group of general surgeons in the Midwest whose policy is for physicians to review advanced practitioners' charts to...
Find Patients We Should Have Seen By Now
Are you missing patients? Today's BIG Idea podcast is from a Rocky Mountain practice who wants to find patients that should have been seen by now but do not have a future appointment. The idea to look for patients you expect to have followed up with in a certain time...
Estimating Patient Charges
Is estimating patient charges time consuming for your practice? Medical practices are used to good faith estimates, but what if a self pay patient's charge is more complex than a simple procedure code? Today's BIG idea is from an orthopedic practice that wants to...
Payer Transparency Market Data
Still thinking about payer transparency data and knowing what your competitors are getting paid? So am I. Today's BIG Idea is an overview approach to what competing medical practices are getting paid. The example is from an orthopedic practice in the Boston area. I...
Benchmarking Payer Transparency Data
Did you find last week's podcast about payer transparency data interesting? Today's BIG Idea is another way to look at your practice's competitor's contracts. The graphic accompanying the podcast shows a OBGYN practice in Central Florida and how contracted rates vary...
What is Your Competing Medical Practice Being Paid?
Are your competitors being paid more for procedure codes than your practice is? How much more? Happy 2024 everybody. I am playing with a new toy this year. Insurance carriers are required by law to publish contracted rates by procedure code, but they have made it...
Medical Practice Revenue Cycle Analysis
How long has it been since you analyzed your practice's revenue cycle? Today's BIG Ideas podcast describes several steps I use when analyzing a practice's revenue cycle. Listen for the data I gather and for a general approach to get started. The graphic on my web...
Follow Patients Through Your Practice
Recent podcasts have discussed tracking how patients come to your practice and how patients leave your practice. Today's podcast is from one of my sessions at the recent MGMA Leaders Conference in Nashville about following patients through your practice. Which...
Mine Clinical Data
I apologize for being a bit behind in podcasts lately. Three weeks ago I spoke at the ASCENT conference in Chicago. Two weeks ago was MGMA's Leaders Conference in Nashville. Last week was Connecticut MGMA in Mystic. I am back in the saddle and today's podcast is an...
Medical Treatment Rate
Want a sneak peak of one of my presentations at next week's MGMA Leaders Conference? One of the top things savvy practice managers are focusing on now is looking beyond charges, payments, and adjustments to follow the paths patients take through the practice. Today's...
Waterfall Reports for Medical Practices
Need a new way to see your practice's revenue cycle? Waterfall reports for medical practices are a helpful way to trend payments. Today's BIG idea describes how to track payments by date of service and get a true collection ratio by month. As that collection ratio...
Track Patients Leaving Your Practice
Several podcasts have discussed tracking patients coming to a practice. Have you tracked how patients leave your practice? Today's BIG Idea is from a physical therapy group where we track the average number of patient visits by provider over time. Listen to today's...
Watch Reason and Group Codes
Looking for more medical practice revenue? How long has it been since you have reviewed your reason and group codes? Reason and group codes are the way insurance companies communicate how and why your charges have been adjusted and not paid. Today's BIG Ideas podcast...
Track New Patients
How are your new patients volumes? What is driving those changes? Today's BIG Idea is to gather as much data as you can around your new patients to understand by age, insurance, location, referral source, diagnosis and more why patients are coming to your practice. ...
Track Urgent Care Referrals
Are your efforts to market your practice working? Today's BIG Idea is to track urgent care referrals in your practice. The example comes from a Midwest orthopaedic group that offers urgent care. The question is how often the advanced practitioners who staff urgent...
E&M Coding Levels
Are your E&M codes billed consistently across providers? Do you have an easy way to tell? Today's BIG Ideas podcast shows a Pivot Table, slicers, timeline, and Pivot Chart I built for a practice to track their E&M coding levels. Listen for ideas on how to...
Marketing Opportunities with Prevalence Rates
Looking for a new marketing idea? Today's BIG Idea is from a pediatric orthopaedic practice that found prevalence rates for a variety of conditions in one of their provider's textbooks. Prevalence rates give them a sense for how many of a specific diagnosis they...
Medicare Provider Utilization Data
How do you compare to similar practices? Would you like to know more? Today's BIG Idea is an example I'm building for a group of dermatologists in Florida. We are using Medicare Provider Utilization Data to compare Evaluation and Management coding levels, market...