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Net Collection Ratio

The net collection ratio is calculated this way: Cash collections divided by net charges.  Net charges are the difference between gross charges and required government and third party adjustments. Use gross charges, insurance adjustments and cash collections for the same time period. Example:  Gross charges = $3,740,318;  Cash collections = $2,070,275;  Insurance Adjustments = 1,588,554 Net Collections = Gross charges-Adjustments  3,740,318-1,588,544=2,151,764. ...

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CMS: Lot of errors billing psychotherapy services when E/M visit is involved

The Comprehensive Error Rate Testing (CERT) program Medicare uses to assess the accuracy of provider billing has uncovered a big source for mistakes – documentation problems when a patient is receiving psychotherapy services on the same date as an E/M encounter, according to CMS. There are really two takeaways coders and billers need to have to get these services billed correctly on a consistent basis. A big part of it will also involve proper physician documentation. First, there a...

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10 top-notch tips to negotiate payer contracts

With a little hard work and patience, practices can succeed at negotiating stellar contracts with payers, Marcia Brauchler, MPH, CMPE, CPC, CPC-H, CPC-I, CPHQ of Physicians Ally, Inc. told attendees at AAPC’s 22nd annual HEALTHCON conference in Nashville, TN earlier this month.   “[Contracts] represent 100% of the revenue to the practice,” Brauchler said. “Everything comes to your practice via payer agreements. The more time you put into payer agreements, the more ...

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Tue, Sep/30/2014 04:53PM
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