Medical Society of the State of New York

Running a medical practice imposes layers of complexity unimaginable by most. One needs to be an expert in medical records, human resources, reimbursements, employee benefits, finance, vendor contracts, compliance, OSHA…. The list never ends. Somehow you are expected to manage all of this while you only want to take care of the health of patients which is why you wanted to be a physician to begin with.

Don’t lose hope. There is help. Join us in our free multiple part educational series to discuss “The Business of Medicine.”

In our second program we will address such topics:

1. Patient abandonment issues in the “traveling” provider world – Here we will discuss how to address patient care and business issues when a traveling provider no-shows or terminates his or her contract on short notice.
2. Permissible employee payroll deductions– This section will focus on what deductions an employer may make from an employee’s paycheck, including, but not limited to, costs related to non-required education and training.
3. Charging insured patients a credit card processing fee – Payor contracts have very stringent terms with regard to what fees can be charged to beneficiaries. We will discuss whether it is permissible to charge patients a credit card processing fee.
4. The importance of negotiating payor contracts – Payor contracts are incredibly one-sided. This section will address the importance of negotiating the terms and conditions of a contract including, but not limited to, fees, assignment provisions, and indemnity.
5. Recent overpayment recovery actions – Here we will discuss two recent overpayment actions from payors.

When you started your practice you likely didn’t realize you were actually opening a business. Many just set up the office, hire a few staff, start scheduling patients, and anticipate it will all work out with a reasonable quality of life.  Boy, did you think wrong. Running a medical practice imposes layers of articulated complexity in addition to traditional business with topics such as Reimbursement Models, Anti-Trust and Stark, Accountable Care Organizations, wRVUs, Risk-Mitigation, OIG, HHS and CMS Compliance. Top this with you needing to be an expert in human resources, employee benefits, accounting and finance, vendor contracts, commercial general liability and OSHA. All of this while you need to take care of the health of patients which is why you wanted to be a physician to begin with.

Don’t lose hope. There is help. Join us in our free multiple part educational series to discuss “The Business of Medicine.”

In the program you will learn:

• Practicing Medicine is not just about treating patients.
• Business principles – both traditional and healthcare driven.
• Learn what risks to avoid and consequential actions.
• Knowing when to seek the right help from the right people.

All of your practice expenses are going up so why would you willingly throw away 9% of your income in penalties and forfeit incentive payments?

That is exactly what you are doing if you elect not to participate in the Merit-Based Incentive Payment System (MIPS).  It is still not too late to start for 2023. Avoid the losses and boost your income.  Find out how.

Enroll today in our free educational webinar that will guide you through MIPS.

In the short program you will:

• Get a better Understanding of the MIPS Incentives and Penalties
• Learn Eligibility Requirements to participate
• Identify Important Dates and reporting time-lines
• Understand the differences of Quality, Cost, Improvement Activities and Promoting Interoperability
• Simplify the complexity of the Key Elements
• Find out which Provider Types are eligible to enroll and the ease of using federal web sites to verify your status

Whether you are new to MIPS or currently participate within the program, this session will enhance your knowledge and make sure you are familiar with any new changes. Take an action now that will increase your bottom line, improve quality outcomes and provide an even better experience for your patients.

The demands of running a modern medical practice requires more time from your office staff. The fact of the matter is that there is just more work to do. The list has grown and become more complex. It is not just about managing insurance claims, referrals and authorizations, greater knowledge is required with insurance mandates, technology requirements including Electronic Medical Records, e-Prescribing, HIPAA, Cybersecurity and…everything else. What time is left for patient care, let alone focusing on managing your Revenue Cycle and cash-flow?

Many medical practices and health-delivery systems prefer to be less involved in the day-to-day of back-office processes including billing, collecting, posting payments, managing denials and calling insurance companies for proper payment. There is a better way. Outsourcing to a skilled and competent Revenue Cycle Management (RCM) Partner. Join our program on March 8th, “Understanding Outsourcing,” to explore the benefits of Outsourcing. Outsourcing does not mean lack of control. Find out how trusted firms provide greater knowledge and experience, are more efficient and effective, are accountable and compliant, and increase net income and cut costs. Learn what questions to ask an outsourcing company in the interviewing process and find out why so many practices are choosing to re-focus their own staffing needs and let the professional focus on the collection your money.

Have you heard about Revenue Cycle Management (RCM)? It is the process of managing the healthcare revenue cycle within your office so that you get paid for what you do. It sounds simple but it is not because medicine is a highly regulated industry, and there are many rules about what you can bill and collect for your services, and when you need to submit those bills.

The revenue billing cycle includes the entire patient billing process from new patient registration to the patient/physician encounter, charge and diagnoses entry and verification; to your back-office processes of entering and sending charges to the insurance carriers, following up to ensure that they were received and entered into the carriers computer for payment and not rejected, making insurance appeals and follow-up if they are incorrectly paid or rejected, spending a lot of time on hold waiting to speak with a carrier, then posting payments and recording the collection to reduce the total balance. And. If the patient has secondary or additional insurance coverage the whole process needs to be repeated before you can send a bill to the patient. All of this must be done within a time frame called “timely filing” or you can’t collect for your work. Once you bill the patient you need to collect and post that patient payment against the balance and that was just for one procedure.

Plus, you need to be paying attention to programs like MIPS to ensure that your payments are not being reduced because you are not using an Electronic Medical Record System with ePrescribing and not following the compliance requirements of the carriers.

So, the key to this process is to have an organized billing staff with the knowledge of regulations that can positively or negatively affect your compensation; have a good, computerized billing software system, and to not make billing errors or lapses that would reduce the amount of monetary reimbursement to your medical practice. Plus, your billing staff needs to have some quiet time without interruptions to do their work. Often this is an issue in a medical office where everyone chips in to do everything especially during medical emergencies, or with patients calling on the telephone to question why the insurance company didn’t pay the whole bill.

There are many coding changes for the 2023 calendar year. The Evaluation and Management code sets that impact virtually all specialties have further revisions. It is critically important to understand the impacts of these changes upon your documentation, work-processes and the potential changes to revenue that might result. Attend an educational update on January 11^th of the Evaluation and Management changes for Office, Hospital and Clinic visits.

You will learn what procedure codes have been added, deleted, and revised as well as the relative descriptors. By becoming more acutely aware of the documentation updates, you will understand what requirements are necessary to support levels of service; moreover, not waste your time on inconsequential notes as the 1995 and 1997 CMS Guidelines become obsolete.

In this webinar, we will introduce you to Cybersecurity Trends that are affecting the Healthcare industry. The cybersecurity landscape keeps evolving as bad characters continue to get more creative. Over the last year, they have come up with new attack vectors and adjusted their tactics to circumvent ways that had been implemented to prevent them in the past.

STI’s Director of Technical Services, Al Toper, is an Air Force veteran with over 40 years in the technology field. Please join him as he shows you these new attack vectors and things you can do to help prevent you from being the next victim.

STI Managed Services is an award winning, full-service IT division within STI. They sell, install, and support technology for hundreds of medical practices, financial companies, and the SMB market. Their team is made up of a large group of IT specialists. They are also a member of the Varnex Community. A national group of MSP companies that provide guidance for the future of IT.

Starting in 2022 changes by Federal and State agencies through the No Surprise Act now require all medical providers and hospitals to maintain accurate records to within 30 days of modification or steep penalties and risk of plan expulsion. Provider credentialing is a regulated process of assessing the qualifications of specific types of providers. This procedure requires providers such as doctors, and other allied healthcare professionals to show they have the proper education, training and licenses to care for patients. In addition to attestations by CAQH, Medicare PECOS, State Health Departments, and legacy platforms.

In this webinar you’ll be introduced to the Provider Credentialing Services and Maintenance options that the STI RCM Credentialing team has, whether it be a one-time need for provider addition/deletion/modification, or one of our maintenance programs to meet the needs of NCQA standards and revalidations.