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Accounts Receivable Blog posts

March 11, 2014
by Simon Hughes

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 luck you might have.” -Ed Bradley, American Journalist We have a saying at PMG… or at least we did in our early days… “We work without nets.” It is not an […]

February 10, 2014
by Simon Hughes

Medicare Sequestration Adjustment Codes Changed

The Budget Control Act of 2011 mandated across the board reductions in government spending.   In 2013 President Obama ordered a payment sequestration reducing Medicare fee-for-service payments by 2% across the board [1].     Medicare had been using Claim Adjustment Reason Code (CARC) CO-223 to communicate those adjustments. In June of 2013 CMS created a new code, […]

January 20, 2014
by Simon Hughes

Procrastination makes easy things hard

“Procrastination makes easy things hard and hard things harder.” -Mason Cooley Sub Title: Procrastination… Big Dates Keep Coming Regardless of Readiness OK. I admit to being a “last minute Louie” for a good bit of my life. I have all the legitimate excuses of being too busy or needing more info or thinking someone else […]

November 4, 2013
by Simon Hughes

Subcommittee on Health Center Finance

FQHC Medicare – Program Assistance Letter 2011-04 As we all know Medicare is growing and is expected to do so for years to come. In the FQHC world, Medicare accounts for just shy of 10% of revenues or $750 million in 2010. Outside of CHCs, Medicare is the undisputed behemoth of the healthcare industry. FQHCs […]

October 21, 2013
by Simon Hughes

Breaking the Denial Management Circle

It is a cold Monday morning in the middle of flu season.   There are patients lined up at your check in desk and the waiting room is full.  Half of the staff has called out sick. There are doctors and nurses standing around anxiously waiting to get these patients into a room. The first patient […]

October 21, 2013
by Simon Hughes

Accounts Receivable Management Tips for CHC’s & More

Accounts receivable, unpaid claims, outstanding invoices – no matter what the label, it is money left on the table and generally, is the task that gets pushed to the bottom of the to-do list. There are volumes of reasons why a claim is not paid with the first submission.  At multiple points in the billing […]

October 21, 2013
by Simon Hughes

Sequestration Impact on CHCs… Can you afford to not maximize every potential dollar?

After reading the Geiger Gibson /
RCHN Community Health Foundation Research Collaborative Policy Research Brief # 32, a product from the George Washington University School of Public Health, it is clear that CHCs should be bracing for the impact of sequestration. Recent releases from CMS about sequestration make it clear that fee-for-service (FFS) Medicare will see […]

October 21, 2013
by Simon Hughes

Testing: The critical step in transitioning from manual to electronic processes

We become very accustomed to ‘the way we’ve always done it’ yet research and implementation of process improvements is necessary for growth.  At the time when many of us started in the healthcare industry, how things were done then are so very different from the way things are done now.  We are no longer using […]

October 21, 2013
by Simon Hughes

Key Peformance Indicators: Net AR & Payment Percentage

What are the two things you should absolutely be looking at each month to determine how well your billing department is running? While there are certainly many indicators that should be looked at on a monthly basis to truly measure the success or lack thereof of your billing department there are two that I consider […]

October 21, 2013
by Simon Hughes

Identifying payers by plan type

Identifying payers by plan type – setting the right expectation or administrative nightmare? Practice management systems have multiple methods for identifying and classifying insurance payers to assist in collecting and reporting data.  It may not be necessary to identify payers by plan type but it certainly makes the billing process more efficient – for staff […]