Dresden Medical Management Group

Whether you’re new in practice or you’ve been at this for years, one of the most important financial foundations you’ll set up is your fee schedule. Understanding how charges, allowable fees, and self-pay rates interact and knowing how to set them appropriately, can protect your revenue, reduce confusion for patients, and keep your billing process running smoothly. First, let’s clarify the core terms. Your charge schedule is the amount you initially bill to an insurance company for a service. This is the “charge” you publish in your system as the standard price for each CPT code. The allowable fee schedule, on the other hand, is what the insurance payer actually agrees to pay you for those services. Payers use this schedule to determine your reimbursement, and it often differs from your charged amount. Then there’s the self-pay (or cash-pay) fee schedule, which is what you charge patients who aren’t using insurance. Self-pay rates are typically a percentage of Medicare or of your stand...

In our recent posts we’ve touched on Old Patient AR. Today we’re focused on how to reduce it, with five practical tips designed to get those balances paid faster. If you’re new to medical billing, a quick refresher: accounts receivable is the money your practice is supposed to receive. Insurance AR comes from your fee schedule and contractual adjustments after services are billed. Patient AR is the portion actually owed by patients. Defining what counts as “old” AR Old AR typically means balances that are 60, 90, 120, or 180 days old and have had at least three statements sent. It can also apply to newer practices with a lot of new AR. The key is to identify what qualifies as old in your office so you can plan your next steps. One: Tackle the Overdue Balances First - outreach and chart flags Start by looking at each patient’s age and the amount they owe, ranking from oldest to newest or highest to lowest. For active patients, add a chart flag so you’re prompted to collect at the next v...

Today, I am sharing the top things that we have seen that make healthcare practices succeed. As we all know, it does get very challenging to run a healthcare practice today. You have to have the right people, you have to have the right processes, and you have to have the right focus to be able to grow and meet the needs of both your staff, your patients, as well as yourself in order to be successful. Knowing these may help relieve some stress, grow revenue, and help your practice continue to give you that fulfillment that you want.  It is so important that practice owners have a focus around what they want from the practice? What are the priorities of the practice? Is it stabilization? Is it growth? Owners should outline their focus, write it down and share that vision with your staff.  If you are the practice owner, you should have a clear vision and a list of priorities you want. This may take some time to create, if you haven’t already. It’s a matter of just sitting down an...