November 29th 2023
Physician details her journey from sustaining career-ending injury to insurance advocate.
The efficiency of an ambulatory surgery center can be accomplished by aligning leadership, having congruent goals of leadership, the placement of a consistent pattern for analysis of processes, problems, and situations in the surgery center, and a courageous leader on the frontline. Finally, and probably the most significant-recognition that quality produces quality.
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Know the guidelines for coding glaucoma tests
August 15th 2008Both Medicare and private payers are known to deny coverage for glaucoma screening tests. Knowing which patients qualify for tests based on medical necessity is important. Also, knowing the rules will prevent abuse, while allowing you to confidently report the services you provide.
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Can a financial professional help you step up your practice?
August 1st 2008Asking a financial advisor to assist with business matters for many physicians and other professionals may seem unacceptable. However, financial professionals focus exclusively on a relatively narrow segment of business operations. Their specialized training and experience may open doors to opportunities that haven't been considered.
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The pitfalls of Medicare physician profiling
August 1st 2008To help reduce projected expenditures, Medicare is turning to physician profiling. Economic profiling gives a certain level of cache to a commercial healthcare plan. It works by profiling every provider in the system for at least 3 years. The goal is to find providers that cost the system less. However it is differentiating on cost of efficiency not on quality.
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A five-star practice is a few quick fixes away
August 1st 2008One's own practice has a lot in common with the standards of a 5 star service. A patient should leave feeling better than when they came in and that it was an overall good experience from the front desk, to the tech, to the doctor. It is a lot to ask to be just like the Four Seasons but little things like displaying flowers or greeting guests warmly can do the trick.
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Congress blocks pay drop, but 21% cut looms in 2010
August 1st 2008Congress was able to block a pay cut for physicians who serve Medicare patients. Even though the American Society of Cataract and Refractive Surgery (ASCRS) and the American Academy of Ophthalmology (AAO) are pleased for the delay in the pay cut they maintain that the hard work is just beginning.
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Safe Harbor 401(k) plan is option for small business owners
August 1st 2007The Safe Harbor 401(k) plan allows for greater tax-deferred savings than the SIMPLE IRA and avoids the bulk of the administrative expenses of the traditional 401(k). Participants are permitted to defer up to $15,500 for 2007, with an additional $5,000 catch-up available to participants age 50 and over. Adding a cross-tested plan could provide larger proportionate contributions to those closer to retirement.
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Hire the right ophthalmologist
August 1st 2007The aging baby-boom population will make eye care a growth industry, resulting in ophthalmology practices adding new physicians. Examine whether the practice really needs to add another physician, avoid overcompensating new hires, and negotiate an associate's buy-in as a partner carefully.
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Safe Harbor 401(k) plan is option for small business owners
August 1st 2007The Safe Harbor 401(k) plan allows for greater tax-deferred savings than the SIMPLE IRA and avoids the bulk of the administrative expenses of the traditional 401(k). Participants are permitted to defer up to $15,500 for 2007, with an additional $5,000 catch-up available to participants age 50 and over. Adding a cross-tested plan could provide larger proportionate contributions to those closer to retirement.
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Three key reasons that general partnerships are liability nightmares
April 15th 2007Never operate a practice as a general partnership, say two consultants on business planning and wealth protection. They say that a general partnership is a creditor or plaintiff's dream and a partner's liability nightmare.
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Pushing the non-covered services envelope into pseudophakic monovision
April 15th 2007Some ophthalmologists have suggested applying the non-covered services concept, as stated in CMS rulings 05-01 and CMS-1536-R, to other procedures that alleviate the symptoms of presbyopia, specifically pseudophakic monovision-cataract surgery with IOLs to create monovision.
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Online coding seminar helps unravel differences between E/M and eye codes
November 15th 2006Ophthalmologists should familiarize themselves with the differences between evaluation and management (E/M) codes and eye codes, so that whichever set of codes is used is appropriately documented to ensure proper reimbursement, according to L. Neal Freeman, MD, MBA, FACS, a certified specialist in physician coding.
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Words of wisdom for a harmonious operation
October 15th 2006St. Thomas, U.S. Virgin Islands-When four leading practice management specialists met as a panel recently, the pearls of wisdom they shared encouraged ophthalmologists to be aware of vital aspects of their business, including finances, human resources, and legal issues. The session, titled "Business, Operation, and Legal Pearls," provided physicians and administrators with suggestions on how ophthalmologists can increase efficiency, maximize profit, and avoid pitfalls leading to liability.
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Dry eyes and wet eyes present multiple coding challenges
October 15th 2006Ophthalmologists know that a very large number of patients in general practice, and in many subspecialty practices, present with eye symptoms that are too dry or too wet. These common situations trigger coding issues that must be understood in order to ensure proper compensation for care of this sizable patient group.
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Base Curve, Nassau Vision, Zyloware all build presence online
October 15th 2006Base Curve, licensee for the Carolina Herrera Eyewear and John Varvatos Eyewear collections, now has a home online at www.basecurveeyewear.com. The site was designed as a resource for eye-care practitioners and consumers, and includes current, comprehensive information on both brands.
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Botulinum toxin gains popularity for variety of disorders
September 15th 2006The use of botulinum toxin by ophthalmologists to treat a variety of disorders has exploded over the past several years. It has highlighted many issues of interest, including off-label use, supply charges, and cosmetic indications. All of these have important implications for coding, billing, and reimbursement.
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Coding for office visits, procedures should be understood
August 15th 2006Some of the most common questions in coding arise when an office visit and a procedure are performed almost simultaneously. For our purposes, "almost simultaneously" will refer to same-day office services for small ("minor") procedures and to previous-day or same-day office services for large ("major") procedures.
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Coding for multiple procedures requires precision
July 15th 2006Medicare rules regarding multiple procedures have been well-outlined and can be thought of as the standard. Most payers closely follow Medicare guidelines in this area. It is still necessary, though, to check with each individual payer for specific instructions. This is especially true regarding the use of the modifiers as discussed below.
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