Practice Management

I applied to get credentialed with another managed-care company but haven't yet received final approval. May I start seeing their enrollees anyway?

I plan to charge a fee for filling out forms for physicals, disability, and family medical leave. Would this policy run afoul of health plan regulations or any other rules?

Our collection agency says that due to HIPAA regulations, it no longer can contact a patient directly if his check bounces. Instead, we must charge the amount back to the patient's account as an unpaid balance and turn the account over for collections. Is this true?

Are RVU-based contracts the standard in today's medical environment?

Eliminating big backups will improve patient satisfaction and relieve stress on you and your staff.

This North Carolina family physician was wary of his insurance carrier's pay-for-performance program, but found the rewards-for him and his patients-were well worth the headaches.

Did the smoking cessation counseling codes change?

Billing for a routine exam which uncovers a serious medical problem must be handled on a case-by-case basis.

How do I bill for service during extended office hours?

I'm tired of waiting for patients who show up late for their appointments. To discourage this, I'd like to have my staff tell anyone who arrives more than five minutes late that she must reschedule for another day. Does this policy seem reasonable?

I'm employed by a not-for-profit hospital. Does that mean I can't collect revenue for ancillary services such as lab work and imaging?

A former associate has filed a claim against me for pay she believes I owe her. In my defense, may I release patient records, including names and financial data, or will that violate HIPAA?

How long after I treat a patient may I bill him for my services? Bills were never sent for some patients I saw between 2002 and 2006. May I bill them now?

Federal regulators are less suspicious of doctors who prescribe opioids for patients, but barriers to adequate treatment remain.

Small changes can make a big difference. This doctor learned to be a better physician-from his mistakes.

After a drug-seeking patient assaulted him, the author truly understood how vulnerable some doctors are.

It's still possible-with a solid banking relationship, a sharp business plan, and ample collateral.

Important as it is to find the right people, keeping them happy and productive is key to a successful practice.

Our multispecialty group recently added a nephrologist, and our staff members are unsure of how to bill for her services. Can you provide some guidance on how to handle capitated and partial month end-stage-renal disease (ESRD)?

We're confused by the time requirements to establish the AHI (Apnea-Hypopnea Index) for coverage of Continuous Positive Airway Pressure (CPAP) therapy. Is it two recorded hours or two hours of actual sleep time?

Our internal medicine practice gives yearly physicals to anyone who requests them, arranging for those whose insurance doesn't cover annual exams to self-pay. Recently, several older patients told us that Medicare now covers this preventive service?a change we're not aware of. Are they right?

To help reduce conflicting incentives and better coordinate care, hospitals and physicians participating in CMS' Acute Care Episode (ACE) demonstration will receive a single bundled payment for Part A and Part B Medicare services provided during an inpatient stay.

For women who call the shots on matters of health for themselves or their families, the healthcare system can be tough to navigate.

Clearinghouses play a key role, too, in determining when?and in some cases, whether?you get paid.

In a third annual ranking of health insurers, Aetna came out on top of 137 national, regional, and government payers in terms of its business dealings with doctors.

It's never been easy to recruit physicians to practice in the nation's smallest communities, and the challenge is likely to escalate in coming years.

Medicare and reimbursement cuts affect doctors

How can I find out whether medical assistants are allowed to give injections in my state, and if they are, what restrictions apply?

I received a request for a deceased patient's chart from someone claiming to be a representative of the patient's estate. Don't I need to verify that she's telling the truth before I release the chart?

We recently found several two-year-old insurance reimbursement checks?one for more than $5,000. The checks are marked "void after 90 days" and the patient is now insured by a different carrier. What should we do?