BIG Ideas from The Business Intelligence Guy

Today’s BIG Idea comes from data analysis projects I do for healthcare consultants.  This consultant is working with a group that outsourced their billing and then had revenue cycle challenges.  Today’s podcast describes an unusual challenge — the billing company was not consistently and correctly charging the billed charge per the fee schedule.  The podcast describes how we used...

Today’s BIG Idea is from a practice in the Midwest who had a payer deny a claim because the pre-authorization was for one day and the day of the procedure moved.  Are pre-authorizations giving your practice headaches, too?  Listen for ideas from both AthenaPractice and AthenaOne on how to build an exception report to track appointments that may be a problem.  The first step is to reliably fi...

Are you tired of seeing payments reduced due to advanced practitioners and incident to billing rules? You are not alone. Today’s BIG Idea is from a group of general surgeons in the Midwest whose policy is for physicians to review advanced practitioners’ charts to ensure maximum reimbursement.  The analysis in the accompanying graphic shows some of the analysis we did to determine which...

Are you missing patients? Today’s BIG Idea podcast is from a Rocky Mountain practice who wants to find patients that should have been seen by now but do not have a future appointment.  The idea to look for patients you expect to have followed up with in a certain time period is common to many specialties and can help retain patients you may lose.  After all of the marketing efforts you expen...

Is estimating patient charges time consuming for your practice? Medical practices are used to good faith estimates, but what if a self pay patient’s charge is more complex than a simple procedure code?  Today’s BIG idea is from an orthopedic practice that wants to estimate more complex patient charges.  Their idea is to grab all patient encounters with a given procedure code on the enc...

Still thinking about payer transparency data and knowing what your competitors are getting paid? So am I. Today’s BIG Idea is an overview approach to what competing medical practices are getting paid.  The example is from an orthopedic practice in the Boston area.  I took 5 major procedure codes and compared what Anthem is paying competing providers in four counties around Boston.  The graph...

Did you find last week’s podcast about payer transparency data interesting? Today’s BIG Idea is another way to look at your practice’s competitor’s contracts.  The graphic accompanying the podcast shows a OBGYN practice in Central Florida and how contracted rates vary widely in two counties.  The benchmarking report shows where the practice’s contracts fit across all...

Are your competitors being paid more for procedure codes than your practice is? How much more? Happy 2024 everybody.  I am playing with a new toy this year.  Insurance carriers are required by law to publish contracted rates by procedure code, but they have made it very difficult to access those rates.  Until now.  Would you like to see contracted rates by procedure code, payer, NPI number, and mo...

How long has it been since you analyzed your practice’s revenue cycle? Today’s BIG Ideas podcast describes several steps I use when analyzing a practice’s revenue cycle.  Listen for the data I gather and for a general approach to get started.  The graphic on my web page shows several columns you might build in a Pivot Table analysis.  I start by looking at the major procedure cod...

Recent podcasts have discussed tracking how patients come to your practice and how patients leave your practice.  Today’s podcast is from one of my sessions at the recent MGMA Leaders Conference in Nashville about following patients through your practice.  Which provider does the patient see first?  What procedure codes and diagnosis codes are on the first visit?  Where does the patient go n...

The post Mine Clinical Data appeared first on Moore Solutions Inc .

The post Medical Treatment Rate appeared first on Moore Solutions Inc .

The post Waterfall Reports for Medical Practices appeared first on Moore Solutions Inc .

The post Track Patients Leaving Your Practice appeared first on Moore Solutions Inc .

The post Watch Reason and Group Codes appeared first on Moore Solutions Inc .

The post Track New Patients appeared first on Moore Solutions Inc .

The post Track Urgent Care Referrals appeared first on Moore Solutions Inc .

The post E&M Coding Levels appeared first on Moore Solutions Inc .

The post Marketing Opportunities with Prevalence Rates appeared first on Moore Solutions Inc .

The post Medicare Provider Utilization Data appeared first on Moore Solutions Inc .

The post Track Workflow Changes appeared first on Moore Solutions Inc .

The post Adjustments From Billed Charges appeared first on Moore Solutions Inc .

The post Power Automate appeared first on Moore Solutions Inc .

The post Patient AR and Reputation Management appeared first on Moore Solutions Inc .

The post Track Copay Assistance Programs appeared first on Moore Solutions Inc .