As we approach 2025, the Merit-based Incentive Payment System (MIPS) continues to evolve, introducing new challenges and opportunities for healthcare providers. The latest updates bring significant changes across various performance categories, including quality measures, cost measures, and improvement activities. Here’s an overview of the key updates. Threshold and Data Completeness To avoid a negative payment […]
In today’s competitive healthcare environment, maximizing practice revenue is more crucial than ever. For many practices, traditional revenue cycle management (RCM) methods no longer meet the demands of a dynamic market. This is where RevXL, Svast Healthcare Technologies’ cutting-edge Practice Revenue Maximization System, steps in as a game-changer. Why Practices Struggle with Revenue Leakage A […]
In healthcare practices, one of the most pressing concerns is managing claim denials. Denials not only reduce revenue but also burden staff with additional administrative tasks. For many practices, this challenge is compounded by the increasing number of denial codes and complex reasons for denials. According to industry experts, denials can range from 8% to […]
In New Mexico, Behavioral Health (BH) agencies play a vital role in delivering specialized treatment and training to providers seeking independent licensure. These agencies provide an array of services, from comprehensive community support to opioid treatment programs. To effectively manage the complexities of Revenue Cycle Management (RCM) and credentialing, healthcare practices must stay compliant with […]
In many healthcare practices, medical billing is often an overlooked aspect, treated as a tedious task rather than a critical function. Billers are frequently left to work in isolation, away from the main practice areas, despite being essential to the organization’s cash flow. However, the efficiency and accuracy of these billers directly impact revenue, and […]
Medicare’s Targeted Probe and Educate (TPE) audits are designed to identify and correct billing errors in a more “warm and fuzzy” manner compared to traditional audits. While the process might seem intimidating, understanding the TPE audit’s structure and requirements can help healthcare practices better prepare and respond. This comprehensive guide will break down the TPE […]
Payer agreements are contractual arrangements between healthcare providers and payers, ensuring that providers receive proper reimbursement for the care they provide to patients covered under specific payers. These contracts are essential for several reasons, benefiting providers, payers, and patients alike. Ensuring Timely Reimbursement One of the primary advantages of payer agreements is the assurance of […]
In 2021, 60% of healthcare payments were tied to value and quality-based care, while 40% originated from fee-for-service models. These two systems are often viewed as polar opposites in the healthcare industry. While the adoption of value-based care is increasing, fee-for-service remains a significant component of the healthcare payment landscape. It’s crucial to understand both […]
In today’s healthcare landscape, managing the revenue cycle is crucial for the sustainability of any medical organization. The financial health of a practice hinges on effective patient payment collections. If your practice is diligent in sending out statements but faces challenges in collecting payments, it will inevitably affect your bottom line. To ensure the financial […]
Starting a new medical practice is a challenging endeavor. Many new practices fail due to a variety of reasons. Here are the top five reasons why new practices fail, accompanied by real-life examples: 1. Doctor’s Underestimate the Work Involved A primary care practice in Savannah, GA underestimated the amount of work it takes to customize […]
