Discover how HCPCS code G0537 & G0538 can help your practice capture additional reimbursement for managing complex patient care.

Learn how HCPCS G0559 helps you get paid for managing postoperative care for surgeries performed by another provider.

Discover how HCPCS codes G0556, G0557 and G0558 can help your practice capture additional reimbursement for managing complex patient care.

Discover how CPT code G2211 can help your practice capture additional reimbursement for managing complex patient care.

When managing patient balances, deciding between a payment plan and collections can impact both your practice’s finances and patient relationships. Explore the advantages and considerations of each approach to maintain financial health while fostering positive patient experiences.

Choosing the right practice management software is a game-changer for any growing medical practice. Discover how the right PMS can streamline operations, improve patient experience, enhance billing, and support regulatory compliance, all while preparing your practice for future growth. Dive into the essential features that make a PMS invaluable for success and efficiency.

A well-trained front desk team is essential for creating a smooth and positive experience in a medical practice. Discover the best practices that can transform front desk interactions into meaningful patient connections and support the overall success of your practice. Read on to learn how small adjustments can make a big impact.

The 2025 Medicare Physician Payment Schedule (PFS) and Quality Payment Program (QPP) Proposed Rule outlines key updates, including a 2.80% decrease in the Medicare conversion factor, potential new policies for telehealth, adjustments in payment for specific services, and expanded preventive and behavioral health initiatives. These changes emphasize telehealth support, preventive care, and cost alignment with practice needs, aiming to keep healthcare policies responsive and efficient for providers.

Recruiting healthcare providers for a growing practice is essential for maintaining high-quality patient care. From defining clear job roles and leveraging medical job boards to conducting thorough screenings and offering competitive benefits, every step ensures you find the right fit for your team. Here’s a comprehensive guide to help you recruit effectively and set the stage for long-term success.

Expanding your medical practice by adding new providers can boost patient care and meet growing demand. From identifying the right roles and handling credentialing to onboarding and marketing, each step ensures smooth integration and sets the stage for a thriving, collaborative team. Here’s a step-by-step guide to help you through the process.

Reducing claim denials is key to a smooth revenue cycle and financial stability for healthcare practices. Discover five proven strategies to minimize denials, streamline billing processes, and enhance cash flow, allowing your team to focus more on delivering quality patient care.

Evaluating your medical billing team’s performance is essential for maintaining a healthy revenue cycle and efficient cash flow in your practice. Key metrics like days in accounts receivable, clean claims rate, and denial rate offer insight into billing accuracy and effectiveness. Ensuring timely claim submission, proactive follow-up, and adherence to compliance standards helps streamline operations and maximize collections, while strong communication and customer service skills enhance patient satisfaction. Here’s how to assess if your billing team is truly optimizing your practice’s financial health.

In 2024, ten states implemented reforms to streamline prior authorization processes, reducing delays in patient care and administrative burdens through measures like extended authorization validity, faster response times, and increased transparency.

Outsourcing medical billing offers a wide range of benefits, from streamlined cash flow to increased revenue, allowing you to focus on what you do best—patient care. By partnering with billing experts like Zoo Health, your practice can improve payment speed, reduce administrative burdens, and stay current with ever-changing industry regulations. Ready to enhance profitability and minimize stress? Discover how outsourcing with Zoo Health can elevate your practice!

Starting a medical practice involves careful planning across several key areas, including legal setup, financial planning, operations, staffing, and marketing. To ensure compliance, secure necessary licenses, malpractice insurance, and HIPAA-compliant policies. Budget for startup costs and invest in essential technologies like EHR systems and practice management software. Hiring and training staff, creating an online presence, and building patient acquisition strategies are crucial for growth. Additionally, establishing insurance contracts and prioritizing patient satisfaction will help you maintain a steady and engaged patient base. Successful practices balance high-quality care with efficient, well-managed business operations.

Deciding whether your medical practice should accept insurance or only cash payments is a significant decision that can impact your business model, patient base, and revenue flow. Here are the key considerations for both options: Accepting Insurance: Pros: Larger Patient Base: Many patients prefer to use their insurance, so accepting it can increase your patient pool. Higher Patient Retention: Patients who use insurance may be more likely to stick with your practice long-term. Perceived Accessibility: Accepting insurance may make your practice seem more accessible and affordable, attracting more patients. Billing Options: Some patients are more willing to pursue care when they know insurance will cover part of the cost. Cons: Administrative Burden: Processing insurance claims is time-consuming and can require dedicated staff or outsourcing. The paperwork, pre-authorizations, and follow-ups with insurance companies can be complex. Delayed Payments: Insurance companies can delay payments or even deny claims, leading to inconsistent cash flow. Lower Reimbursement Rates: Insurers often negotiate lower rates for services, meaning you may earn less per visit compared to cash payments. Compliance and Audits: Accepting insurance requires adhering to strict documentation, coding, and regulatory standards, including the possibility of audits. Cash-Only Practice: Pros: Simplified Billing: A cash-only model simplifies operations, eliminating the need for insurance paperwork, billing, and follow-up. This reduces administrative costs. Immediate Payment: You get paid directly at the time of service, leading to a more consistent and reliable cash flow. Higher Flexibility in Pricing: You have control over your pricing without negotiating lower rates with insurance companies. Focus on Care: By removing the insurance system, you can focus more on patient care and spend less time on administrative tasks. Cons: Smaller Patient Pool: Many patients may not be able to afford out-of-pocket payments, limiting your potential patient base. Perception of Inaccessibility: Some patients may view a cash-only practice as less affordable or exclusive, which could hurt your practice’s reputation, depending on the demographic. Patient Responsibility: Some patients may struggle to pay in full at the time of service, leading to fewer repeat visits or incomplete treatment plans. Middle Ground: Hybrid Approach Many practices choose a hybrid model, accepting insurance for certain services but offering cash-only or concierge options for others. This gives you the best of both worlds, allowing you to cater to a broader audience while simplifying certain parts of your business. Key Questions to Ask: Who is your target patient demographic? If your target market is middle- to high-income patients, a cash-only model might work, but if you serve lower-income patients, insurance may be necessary. How much time and resources can you devote to administration? A cash-only practice frees up time and reduces admin costs, but it may limit patient access. Are there specific insurers that are particularly strong or weak in your area? Some insurers are more patient-friendly or easier to work with in certain regions. What type of patients do you serve and what is your practice’s focus? This could help tailor the decision further.

Navigating the credentialing process is crucial for medical practices that plan to accept insurance. Credentialing verifies qualifications, allowing providers to join insurance networks and accept private and government payers like Medicare and Medicaid. Key steps include preparing documents, creating a profile on CAQH ProView, applying to target payers, and negotiating contracts to maximize reimbursement rates. Regular follow-ups ensure timely progress, while maintaining updated credentials helps avoid lapses in participation. Starting early and staying organized can streamline the process, making credentialing an essential step for financial sustainability in healthcare.

Attracting new patients to your medical practice requires a mix of digital marketing, patient-focused service, and community engagement. Building a strong online presence, including a professional website, SEO, and social media, helps potential patients find and connect with you. Patient referrals, community involvement, and managing online reviews further boost visibility and trust. Offering conveniences like telemedicine and extended hours can set your practice apart, while paid advertising and a smooth patient experience keep your services top-of-mind. Together, these strategies enhance patient satisfaction and promote consistent growth.