Benefits of Patient Financing: 4 Practices Speak Out

KZA News Brief by Cheryl Toth, MBA, Consultant and Speaker Deductibles and coinsurances continue to skyrocket. Many Affordable Care Act (ACA) exchange plans have deductibles of $5,000 or more. The result is that more and more patients are finding it difficult to come up with surgery deposits or pay for elective procedures. Offering payment plans…


The Revenue Engine that Could “Think You Can” by Refining the Revenue Cycle with the Right People, Processes, and Tools

Greenbranch – May/June 2013 Kim Pollock, RN, MBA, CPC Many physicians continue to wrestle with an economy-in-recovery and declining reimbursements. In this business climate, practices can’t afford reimbursement process mistakes and inefficiencies; they’re simply too expensive. Just a few denied surgical claims can cost a practice thousands of dollars. That’s the cost of the annual electronic…


Billing and Collections Staff Knowledge Assessment Tool

Message to the manager who may use this assessment tool: All or portions of the following questions can be used for interviewing/assessing candidates for open positions in various reimbursement related functions in the practice and with existing employees to assess their understanding of topics. If used for existing employees important to stress that it is…


Minor Procedure at the Time of Service Language

Explanation of billing when performing a minor surgical procedure in the office, e.g. fiberoptic flexible laryngoscopy, nasal endoscopy. This letter could be given to patients to explain that the AMA CPT coding rules requires the physician to report a CPT code that is defined by the payor and the AMA as a “surgical” procedure. Download…


Billing Service Evaluation Checklist

Use this checklist with each billing service under consideration. Mark each item on the list to indicate that you have requested or inquired, and that the billing service has responded with the information. In addition to completing the checklist, evaluate the company’s profile and service costs for a complete comparison. Download Form


The Cure for Soaring Patient Receivables: 8 Best Practices for Point of Service Collections and Payment Plans

KarenZupko & Associates Inc. – September 2015 by Cheryl Toth, MBA Patient deductibles and financial responsibilities are skyrocketing. According to a 2014 survey by the Kaiser Family Foundation, 80% of all workers now have annual deductibles, and the average deductible amount has doubled over the last eight years. The study showed that today’s annual deductibles…


Reduce Medical Practice Embezzlement Risk by Implementing Cash Controls

Physicians Practice – September 2013 by Karen Zupko and Cheryl Toth, MBA Several years ago, we visited a practice in which the receptionist drove a Jaguar. We were particularly intrigued about this after we learned that her husband had been in and out of work for several years. As part of our engagement, we observed…


ICD-10 Race to the Finish: 8 High Priorities in the 11th Hour

The American Journal of Orthopedics – July 2015 by Cheryl L. Toth, MBA As late as mid-April 2015, a survey of 121 orthopedic practices indicated that 30% had done nothing to start preparing for ICD-10 (International Classification of Diseases, Tenth Revision).1 That’s scary. And even the practices that had begun to prepare had not completed…


Clean Up Your Revenue Cycle Now: 6 Survival Tips for ICD­10 ­Induced Payment Slowdowns

The American Journal of Orthopedics – May 2014 by Cheryl Toth, MBA You have read the scary headlines and dire predictions about ICD-10 claim submission complications and cash-flow crunches. What are you doing to avoid a near-certain slowdown in your revenue cycle this fall? Assessing and improving specific areas of the revenue cycle cannot only…


21st-Century Patient Collections: Implement a Point-of-Service Collections Program Now

The American Journal of Orthopedics – May 2015 by Cheryl Toth, MBA An 8-surgeon group in the Southeast had a history of high patient receivables, the result of a long-held culture of “We’ll submit to your insurance and bill you after insurance pays.” The billing and collections staff worked in the basement—far away and out…


Meaningful Use for Surgeons – It’s Not as Complicated as You Think

The American Journal of Orthopedics – March 2015 by Cheryl Toth, MBA It’s spring. Have you started your Meaningful Use reporting yet? More important, have you begun reporting at all? “Say the words Meaningful Use to most orthopedists, and they usually roll their eyes or shake their heads,” says Cheyenne Brinson, MBA, CPA, a KarenZupko…


Seven Surefire Ways to Start a Nonphysician Practitioner Off Right

The Journal of Medical Practice Management – January/February 2015 by Cheryl Toth, MBA With the proper planning and preparation, nonphysician practitioners (NPPs) can improve physician productivity and increase patient access to the practice. A thorough training and orientation program is vital to optimizing the effectiveness and retention of an NPP. An organized approach to understanding…


6 Action Steps for Getting Documentation Ready for ICD-10

Doctors Direct Insurance Newsletter – Winter 2014 by Cheryl Toth, MBA We are less than a year away from the biggest change to healthcare administration in decades. Yet, many practices are woefully behind when it comes to their ICD-10 conversion planning. And some physicians still mistakenly believe that this is a job for their billing staff….


Ten Key Things Surgeons Need to Know About “Meaningful Use”

ACOS News – August 2014 Cheyenne Brinson, MBA, CPA Say the words “meaningful use” to most surgeons, and the response is usually a sigh, groan, mumble, or headshake. As a consultant who has been helping surgical practices implement meaningful use since its inception, I most often have to debunk myths surrounding the EHR Incentive Program….


Avoid Billing Service Nightmares: Issues to consider before partnering with independent and hospital-based billing services

AAOS Now – April 2014 by Jennifer A. O’Brien, MSOD In addition to the compliance and security issues highlighted in part 1 of this series (“Avoid Billing Service Nightmares,” AAOS Now, February 2014), an evaluation of operations, experience, and costs is essential to selecting the right partner for the provision of billing services. This is…


Five Technologies That Increase Patient Collections

ACOS News – April 2014 by Cheryl Toth, MBA Health insurance deductibles are skyrocketing, and patient financial responsibilities are reaching new heights. Employers continue to move toward higher deductible plans to keep their expenses in check, and many health insurance exchange plans have deductibles of $3,000 or more. And the millions of patients being added…


How Do YouSpell ICD-10 Success? Teamwork Pays Off For a Nebraska Practice

AAOS Now – March 2014 by Cheryl Toth, MBA New West Sports Medicine & Orthopaedic Surgery, Kearney, Neb., is a seven-surgeon practice with seven physician assistants (PAs) and four athletic trainers (ATs). It’s also ready to face the challenges presented by the transition to the International Classification of Diseases, 10th edition (ICD-10) in October. The…


Avoid Billing Service Nightmares: Use Business Rigor to Reduce Your Risk: Part I

AAOS Now – February 2014 by Cheryl L. Toth, MBA Recently, an orthopaedic surgeon remarked that he was thinking about outsourcing his billing so he could avoid learning ICD-10 and make ICD-10 “the billing service’s problem.” But hastily outsourcing billing and collections without carefully evaluating the company can lead to problems. Choosing the wrong billing…


Don’t Get Burned by the Billing Company: Avoid These Revenue, Reputation, & Regulatory Risks

Plastic Surgery News Connection – October 2013 by Cheryl Toth, MBA “It’s a total nightmare!” The physician’s voice was a mixture of fear and anger. He had hired his cousin’s next-door neighbor’s billing company, which had reportedly worked miracles for other practices. But with this physician’s claim volume, the one-woman company quickly fell behind. In…


Redefined Business Associate Agreements Create Concern

AAPC News – August 2013 by Cheryl Toth, MBA Guard against liability when someone else mishandles your practice’s patient records. True story: A journalist reported finding patient medical records at a trash transfer station. An investigation revealed that a Massachusetts physician group’s billing company improperly disposed of the private health information (PHI). Although there was…


Creating Effective Patient Payment Plans

American Society for Surgery of the Hand – April 2011 Cheyenne Brinson, MBA, CPA High deductibles, co-insurance, self pay, oh my! Gone are the days that insurance paid for everything. More and more patients are responsible for a much greater portion of their health care costs leaving you the hand surgeon tasked with collecting from…