medical billing compliance solutions
How great of a doctor you are and how many patients you see in a day doesn’t matter if you do not bill correctly: you will still be short on money, frustrated, and possibly subjected to audits. Proper billing and compliance to regulations for coding and processing claims is incredibly important for a practice. Unfortunately, it’s all too easy to struggle in this area. With a little help and effective billing compliance solutions, however, you can bring your practice up to speed and make the most of your collections.
CHALLENGES IN MEDICAL BILLING
Medical billing is a surprisingly complicated process involving complex medical coding, secure patient information, and insurance provider intricacies along with both state and federal laws. Billing correctly is absolutely crucial for collecting what is owed to doctors for their services. When not done correctly—or when done inefficiently—collections can fall through the cracks, payments can go unapproved, or worse: you could be audited for fraud.
As medicine and things like reimbursements and regulations change, complying to billing standards adjusts as well. It’s up to you to make sure you stay on top of the expectations and regulations so your billing continues to adhere to state and federal standards. This can put a lot of pressure on a small practice, particularly if they perform billing in-house. Even if you have help from a billing service, you have to make sure everything you do and they provide for you is up to snuff.
HOW NEMO NURTURE CAN HELP
Fortunately, you don’t have to approach your billing compliance blind. NEMO Nurture's Medical Billing Compliance program is designed to make sure you are in-tune with current standards and regulations. The program takes an in-depth look at your billing practices and protocols as well as your medical coding. You’re provided with a current compliance manual to refer to when your office bills. The program also audits your baseline coding and documentation practices, checking for compliance and examining your office’s strengths and weaknesses. We’re then able to coordinate a plan of any corrective actions you might need to take to make sure your billing procedures are all correct.
If you use our electronic health records program, we also have elective software that can help you with the billing process and make sure your protocols and coding all complies.
TAKE CARE OF YOUR MEDICAL BILLING TODAY
Billing is a critical factor in seeing patients and maintaining a practice. Without it, you can’t collect everything you’re owed and you won’t stay afloat. Fixing your billing compliance issues can be a challenge; however, it can protect you from costly audits that could sink your practice. This isn’t an area where you can afford to be complacent. If you know you have billing issues, take charge of them today.
Billing can be complicated, but it should help you succeed, not hold you back. Increasing your collections (and thus your profits) and avoiding audits is as simple as implementing effective, efficient billing.
Let NEMO Nurture help you take charge of and improve your medical billing overall.
virtual practice management institute
Sometimes, in medicine, it can feel like the only constant is change. Regulations, technology requirements, and reimbursement methods are all changing, and it’s almost all a physician can do to keep up—especially when it comes to MACRA and Value-Based Medicine. The good news is that data and knowledge can help you thrive, even as your Medicare and Medicaid reimbursements change. The Virtual Practice Management Institute (VPMI) partnership between NEMO Nurture and Top Practices is designed to provide physicians with exactly the data and the knowledge needed to truly succeed.
A BRIEF VALUE-BASED MEDICINE RECAP
Value-based medicine is a method of reimbursing doctors based on quantifying patient outcomes as well as the cost of treating them. The idea is that by focusing on patient care and cost containment, the quality of care will increase while the costs overall will decrease. This is a change from the basic fee-for-service model, in which doctors are paid directly for the services they provide.
Instead, a program called MACRA will use four criteria to evaluate doctors: Quality (PQRS measures), Advancing Care Initiative (meaningful use), Clinical Quality Improvements (field-specific data measurements), and Cost (specifically to Medicare and Medicaid). A doctor’s compliance in each of these four fields will be tallied and given a score. The composite score is compared to your peers, then used to determine your unique reimbursement pay scale. If you score higher than your peers, you’ll receive a bonus; if you score lower than average, your pay will be “adjusted” so you receive up to 9% less.
WHAT YOU NEED TO THRIVE
This is a huge adjustment for doctors in all fields. Many physicians are wondering how they can possibly comply and avoid expensive penalties or audits each year. The good news is that you can thrive. Using data and good practice management, you can figure out exactly what you need to do to get the most out of your potential reimbursements.
Data from your EHR programs can help you discover where you’re doing well with compliance, where you need some work, where you’re missing opportunities, and your own unique cost/compliance ratio. You can then use that knowledge, as well as practice management techniques and strategies, to make the most of your reimbursements.
HOW THE VIRTUAL PRACTICE MANAGEMENT INSTITUTE CAN HELP
This is where NEMO Nurture's unique services can help you make a big difference for your practice. We have partnered with Top Practices to provide podiatrists with the Virtual Practice Management Institute (VPMI). This incredible program enables podiatrists to measure and monitor the important data they need, then learn how to use it to make the most of their reimbursements and practice management.
The program combines our own powerful Virtual Practice Optimization (VPO) analysis, our coaching and mentoring, and special courses with the Top Practices practice management program.
Our VPO analysis uses your own EHR data to lay out a clear picture of your practice: your strengths, your weaknesses, and your missed opportunities relative to 2,000 of your peers. Proper interpretation of this data shows you where you’re doing well and what things will need to change. Along with our unique coaching and mentoring program, this enables you to expand on what you do well and make adjustments to your practice management where it’s needed.
The Top Practices practice management program is an incredible educational tool to help you improve your practice’s organization and efficiency through proper management. The program includes a massive online library of resources, weekly coaching and mentoring opportunities with management expert Tina Del Buono, and monthly leadership learning opportunities for doctors with experienced podiatrist Dr. Peter Wishnie.
TAKE THE OPPORTUNITIES YOU NEED MOST AND THRIVE
The VPMI program is designed with two basic program tiers so you get exactly what your practice really needs:
Silver package – This involves a monthly VPO analysis and coaching opportunities with Dr. John Guiliana and Dr. Alan Bass through NEMO Nurture. Our team will not only monitor and measure your data, but we’ll also interpret it for you and help you with next steps so you can make the most of your knowledge.
Gold package – Not only do you receive all the VPO benefits and coaching through NEMO Nurture, but you and your staff will also be entered into the Top Practices practice management program, giving you access to their library of resources and expert coaches. This helps you go beyond using your data to learning strategies and techniques to improve your practice management as a whole.
Ultimately, data, knowledge, and coaching are your most powerful tools for thriving under Value-Based Medicine. This is your opportunity to make the most of your reimbursements and avoid the stress so you can continue what you do best: treating patients. No matter what you chose to do, you can’t afford to put your head in the sand and ignore MACRA and other coming changes. Set your practice up for success through the VPMI program instead.
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