MLR

Category: Healthcare

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Improved contact between physicians and their patients — known as “etiquette-based communications” — would improve the “inpatient experience” and could help a patient recover more quickly, a randomized trial found.

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It turns out that keeping patients in the hospital for just one day longer can saves lives, lower costs and reduce readmissions. That’s the conclusion of one study from the Columbia University Business School entitled “Should Hospitals Keep Their Patients Longer?”

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Nearly every physician has claims denied from time to time. Medicare, as a government program, has its own way of doing things. As you know, the process is different from insurance companies, which also have their own way of handling claims.

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The bane of every physician’s practice is when payers deny claims. There are numerous reasons why payers deny claims, with the predominant reason being a paperwork error. Other reasons include misunderstanding on the part of the insurance company, the physician or the patient. There are four key elements in appealing claims that have been denied.

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If there’s one thing that can harm the success of a medical practice, it’s having patients spending too much time in the waiting room.

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Practicing medicine today is increasingly challenging, and the pace of change isn’t getting any slower. To stay viable, practices have to face the challenges head on and develop strategies to thrive in a value-based payment environment. A new provides materials to meet these challenges.

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The Centers for Medicare & Medicaid Services has modified the Medicare Shared Savings Program to increase participation in accountable care organizations.The program is designed with several tracks. Track 1 is risk free. Track 2 participants share in both potential savings and losses. The new rule adds flexibility, updates benchmarks and adds a third track offering greater reward in relation to greater risk. (11/9/2015)

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It’s full steam ahead in the Department of Health and Human Services’ effort to increase participation in accountable care organizations and use financial incentives and quality metrics to determine how providers are paid. (10/26/2015)

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Your practice may be facing lost productivity as a result of the conversion to ICD-10. Claim rejections or delays in payment may jeopardize healthy cash flow. The good news is that Medicare fee-for-service Part B claims will be processed and not audited through Sept. 30, 2016, as long as providers include a valid code from the right family of codes.(10/12/2015)

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Just as every patient has numbers, whether blood pressure, cholesterol, pulse or white blood cell count, your practice does, too. And similar to your patients’ numbers, your numbers need to be in a healthy range. Any negative trends need to be noted, watched and addressed. (9/28/2015)