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Managed Care Contracting & Reimbursement Advisor tells you exactly what you must know and do to successfully negotiate the best deal with HMOs, PPOs, and other payors - and get bigger and faster reimbursement!

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Managed Care Contracting and Reimbursement Advisor

Issue 3, March 1, 2012 - VIEW THE FULL ISSUE

• Understand three-day DRG ­payment window to improve reimbursement

  CMS' rule for billing preadmission nondiagnostic services has long determined how physicians can...

• 5010 enforced this month, so take action now

  Complying with the new 5010 HIPAA transaction standards could require practices to upgrade or even...

• Improve patient billing experience to increase revenue

  Patients today are overwhelmed by the complexity of medical bills. Physicians regret their...

• CMS adds coverage for services to reduce obesity

  CMS announced recently that Medicare is adding ­coverage for preventive services to reduce...

• Legislation aims to ensure prompt payment for Medicaid providers

  U.S. Reps. Brian Bilbray (CA) and Anna G. Eshoo (CA) introduced legislation recently to ensure that...

Issue 2, February 1, 2012 - VIEW THE FULL ISSUE

• You have more leverage than you think when dealing with denials

  Denials can wreck your revenue stream, but physician practices often give up on payment too soon...

• Incident-to billing in OIG's sights this year

  HHS has put physician practices on notice that it will be taking a close look at billing under...

• 5010 deadline extended but MGMA, AMA say threats still exist

  CMS' Office of E-Health Standards and Services (OESS) has announced a 90-day period of...

• Final 2012 physician payment rule with GPCI improvements

  The final 2012 Medicare physician payment rule from CMS includes an adjusted fee schedule for the...

Issue 1, January 1, 2012 - VIEW THE FULL ISSUE

• ACO final rule removes many hurdles, makes option more appealing

  Physicians and practice managers have been trying to decide for months now whether an accountable...

• ACO antitrust fears addressed by FTC, DOJ

  Any consideration of joining an accountable care organization (ACO) quickly leads to concerns about...

• CMS announces primary care initiative, solicits participation from payers

  CMS has announced plans to develop a Comprehensive Primary Care (CPC) initiative in which it is...

• CMS proposes first real revision in Medicare CoP since 1986

  CMS has proposed what would be the first significant revision in the Medicare Conditions of...

• RAC auditors find $92 million in Medicare overpayments

  CMS recently released a report to Congress detailing how RACs found $92 million in...