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MGMA COVID-19 Medical Practice Reopening Checklist

Do you know what it will take to open your medical practice?  Recently, the Medical Group Management Association (MGMA) provided a COVID-19 MEDICAL PRACTICE REOPENING CHECKLIST that is a great tool to help you navigate this next phase.  Many providers may think that as soon as you announce the re-opening that the patients will come but that may not be true.  So, it is best to plan ahead.  This is a great resource to help you determine your reopening readiness. 

The MGMA has been a leading association for medical practices, administrators and executives since 1926.  They are a national organization representing more than 40,000 medical practices of all sizes, types, structures and specialties.

Billing and Collections is a Team Effort!

Rub employees the right wayIf you want your billing and collections to be as smooth and effective as possible, it must be a team effort.  It can’t be up to just a couple of people and it definitely can’t be a blame game.

Practices are overwhelmed with phone calls, paperwork, pre-authorizations, and patient care.  Sometimes the ‘paper’ things can fall through the cracks.  It is these things that end up snowballing and result in more work, frantic calls and denied claims.

Here are some tips that will help smooth out the process.  They may seem insignificant or deemed to be more trouble than they are worth.  But, in the long run, if everyone on the team does their part, it means less clean-up work, less stress, and faster payments.

The collection process starts BEFORE the patient shows up for their appointment.

  1. If the patient is new to the practice send a welcome packet with all of the paperwork that they need to complete.  Sending it before the appointment helps to ensure they will have all of the correct information.
  2. If they are established patients then remind them to bring their current insurance card.
  3. On the day of the visit, ask to see a copy of the patient’s insurance card.  Too many times this step is either omitted or the staff will just ask if anything has changed.  Most patients will automatically say no simply because they don’t remember.  Insurance plans change more frequently these days, so it is best to verify and update all information at every visit.
  4. Make sure that the name on the insurance card matches exactly to what is entered in your practice management system.  Mis-spellings, missing middle initials, and typographical errors will all result in denied claims.
  5. Collect all outstanding patient balances before the patient goes into the exam room.
  6. Make it as easy as possible for patients to pay their deductibles, copay or self-pay payments.  Allow payments via credit cards, patient portals, mobile devices, and paper checks.
  7. Train select employees to set up payment plans for those patients that can’t pay their portion of the bill in full.  Make sure your back office or billing company knows of these payment plans so they can track compliance.
  8. The billing staff or company can’t bill and collect if charges aren’t submitted.  Make sure that charges are submitted daily.  There should be a check and balance to ensure that a charge was submitted for every patient that had an appointment that day.
  9. Make sure that coding is accurate.  Do you have the correct modifier?  Are the number of units correct?
  10. Make sure the pre-authorization/referral matches the service and the date of service exactly.  Make sure the information is noted on the claim.

When everyone on the team takes their part of the billing and collection process seriously things will go much smoother.  The practice will see an increase in revenue and the staff won’t struggle with clean-up work.  That is a win for everyone.

What Are the Top 10 Phishing Email Subject Lines from Q2 2018?

Hackers are constantly throwing in new and clever phishing attacks that threaten email users’ security.  KnowBe4, one of the top security attentiveness and simulated phishing platform contributors recently issued the top 10 phishing email subject lines from this year’s second quarter. Please note, the attacks used most often contain email subject lines that relate to a user’s passwords and security warnings.

An estimated 1 out of 3 people will open a phishing email each day. This tricky way of gathering people’s personal and financial information is getting bigger, despite all the warnings from technology experts.

What is Phishing?

Phishing is a technique that hackers practice to steal personal information, like credit card info or login authorizations. The hacker replicates an existing login page from an online service such as Dropbox, Apple, Gmail or your financial institution. This made-up website holds a code that delivers all the personal data you submit directly to the hacker. To lure you to the bogus website, hackers send a believable email to you. Quite often, the email sent to you will ask you to log in to your bank account because your bank has exposed a transaction that you did not authorize.

Hackers can make these emails look and sound real and their exploits have been very successful. They often use fear. The email will make it sound like you need to take action NOW! So without really checking, the victim clicks the bad link and continues to the bogus landing page where they give the cyber thief their log-in and password information.

Why is Phishing a Concern?

It is reported that consumers, businesses, and organizations will lose an estimated $9 billion in 2018 globally. With so much personal information tied to finances now shared online, hackers use phishing in order to illegally steal your money.

The Anti-Phishing Working Group (APWG) latest quarterly release reported:

  • Over 11,000 phishing domains were created in the last quarter alone.
  • The number of phishing sites rose 46% over the previous quarter.
  • The practice of using SSL certificates on phishing sites continues to rise to lure users into believing a site is legitimate.

Is Phishing Just a Risk for Personal Users?

Because they store a lot of files in the cloud, Phishing is also a risk for all kinds of companies:  Digital design companies, financial institutions, security companies, etc. According to, there were 868 reported company security breaches or cyber-attacks in 2017.

What do Hackers need to be successful?

There are generally three things hackers do to gain access to your information:

  • Build an email account to send emails
  • Buy a domain and set up a fake website
  • Think of a tech company that is used often to mask itself as a legit website (Dropbox, Amazon, eBay, etc.)

What Can I Do to Avoid Phishing?

It has become increasingly difficult to guard yourself against phishing. As hard as Apple, Google, and other tech companies have worked to filter them out, hackers are always devising new ways to phish. However, here are some tips on spotting phishing emails:

  • Try to avoid clicking on buttons and/or links in emails.
  • Begin using password managers. A password manager aids the user in creating and retrieving complex passwords and storing the passwords in an encrypted database. Therefore, if hackers get one of your passwords, they can’t use it on any of your other accounts.
  • Don’t put total faith in the green lock icon in your address bar. This only ensures that it is a private channel but does not inform you about who you’re communicating with.
  • Allow 2FA (two-factor authentication). Two-factor verification is an extra layer of safekeeping otherwise known as “multi-factor authentication.” 2FA requires a password and username, and also something that only the user knows (mother’s maiden name) or has (passcode texted to another device, such as a cell phone).
  • Be extra cautious if the browser plugin of your password manager doesn’t show your login credentials automatically.
  • Be quick to report suspicious emails to your friends and colleagues. Organizations who make it easy for their employees to report attacks will see a significant decrease in cyber-attacks. The quicker an IT department can respond to a threat, it will minimize the threat potential damage inflicted on people.

Ironically, the trend for most of these phishing emails are warnings about security alerts.

Here are the top 10 from Q2:

  1. Password Check Required Immediately (15 percent).
  2. Security Alert (12 percent).
  3. Change of Password Required Immediately (11 percent).
  4. A Delivery Attempt was made (10 percent).
  5. Urgent press release to all employees (10 percent).
  6. De-activation of [] in Process (10 percent).
  7. Revised Vacation & Sick Time Policy (9 percent).
  8. UPS Label Delivery, 1ZBE312TNY00015011 (9 percent).
  9. Staff Review 2017 (7 percent).
  10. Company Policies-Updates to our Fraternization Policy (7 percent).

By: Julie Kastner, Phoenix Technology

August 2018

5 Common Reasons Your Claims are Bouncing Back

Billing is a complex and often tedious procedure, especially with ICD-10 codes. However, the reasons for returned and delayed claims often boil down to a few basics. Here are some of the most common billing mistakes practices make, and how to make sure your practice avoids them.

  1. Little Typos, Big Headaches

    Often reimbursements are delayed or denied because of very small, easy-to-make mistakes. “When I was assistant director of billing for a large multi-specialty practice,” says Brennan Cantrell, “the front office would often transpose the numbers or letters in policy number or omit a group number or plan ID. The front desk is extremely busy, and these are easy mistakes to make.” Cantrell, who is now commercial health insurance strategist for the American Academy of Family Physicians, says that the ideal solution is having an employee dedicated to watching for and correcting these errors. For small practices, this may not be a full-time employee, and the time saved by not having to resubmit claims might offset the time spent rooting out mistakes.

  2. Something’s Missing Here

    Sometimes payers delay payment because you didn’t send enough information. Often you can see this coming. “For example, when you file workers’ compensation claims, you will always need to submit documentation with the claim,” says Tammie Olson of Management Resource Group, an Ocean Springs, Miss., a firm offering financial management and support services for the healthcare community. “If you know you need to send the documentation to get a claim paid, do so when you file.”

  3. Please Ask First

    Another incredibly easy—but costly—mistake is not getting prior authorization. “Before you perform procedures, make sure you verify whether or not a prior authorization is required,” says Olson. “If it is, send in the request before scheduling the procedure.” And when you get ready to bill the procedure, “make sure the authorization number is on the claim,” she adds. Prior authorizations can be a pain, but having a routine for them when they are necessary can save time and prevent payment delays.

  4. Let Me See that One More Time

    Claims are increasingly denied because the patient’s coverage has been terminated or the plan or payer has changed.  Most of the time everything is just as it was the last time the patient came in but you should still ask to see the patient’s insurance card at every encounter. “People change insurance plans more often than they used to,” says Cantrell. “It’s a simple thing, but important.” Olson agrees, and adds, “If you do this, you should never have a claim denied for “policy terminated.”

  5. Keep up with the Changes

    Even when policies haven’t changed, what is and is not covered on a given plan sometimes does. You can be left holding the bag if a payer changes its policies about what procedures they cover or what labs they use, and you don’t hear about it. “Most payers send out a policy bulletin announcing these changes,” says Cantrell, “but it’s difficult to find time to keep up with this.” Large practices often have administrators who watch for these changes and pass the word on to each billing office. However, in smaller practices that job may fall to the front desk or billing staff. Make sure whoever does this understands the importance of carefully reviewing these bulletins when they are issued.


By: Avery Hurt

Ms. Hurt is a freelance writer based in Birmingham, Ala. Her work has appeared in publications including Newsweek, The New Physician, Muse, Parents, USA Today, and the Washington Post

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