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Vachette Pathology
Business Management Consultant
Today 9:00 am – 5:00 pm
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Vachette Pathology

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Updates from the Health Care Financial Managers meeting in steamy Las Vegas: The big news is that many RCM firms are “re-patriotating” their work, this means they are bringing work back on-shore from off shore firms. The other big thing is that many hospitals are simply struggling billing and collecting for their hospital owned practices. Most CEOs and CFOs we spoke with, we talked to over 50, noted that they thought that bundled payments would have been implemented sooner and they worry about staying profitable while waiting for this transition to take place.
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I attended the Ohio Hospital Association meeting this week. Here is what I learned: Everyone is scared to death about the Health Exchange plans. No one is ready for bundled payments. Those hospitals that purchased physician groups are worried about the cost and revenue for these practices.
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Since January 2014, there are more and more issues coming out of the woodwork with FSH billing and reimbursement. 

Read More!

#Pathology #FSHBilling #FSH   #FSHReimbursement  
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A payer recently dropped their payments 30%! There was no reason given. We sent a termination letter…there was no reason given. Why accept a 30% pay cut from a publicly traded company that makes a 5% margin each year? Where is our 5% growth? Come-on! Negotiate a better living!
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CMS recently redesigned their claim form so it could handle ICD-10 codes. We all know what happened to the ICD-10 deadline. We are seeing denials because some payers do not accept the old claim form. (CMS–1500 version 02/12 replaced version 08/05.) 

We are finding some payers are denying claims billed under the older form, for example: As of 4/1/14 Florida Medicaid providers must use this new version of the form. Also, Total Claims Administration will no longer accept the CMS-1500 claim form (version 08/05) beginning April 1, 2014.
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Communication! We found a situation where the biller was told “do not bill cases that are not coded these are No Charge cases.” Well our audit found that 2% of all the cases were showing up not coded and that most of these should have actually been charged! In this case it was approximately $900,000 a year in lost charges. Ouch.
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Have them in circles
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Vachette Pathology

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Are You Losing Revenue from Improperly Handled Denials?
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We found a hospital based practice in the Twin Cities area where the biller was charging less than BCBS was willing to pay! The biller fixed the error for our client and then told all their other clients that they had found this issue and took the credit for our victory. Classic!
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Beware the “replicated EOB” This is an EOB that a biller may use to show the allowed amount. We have found billers and insurance plans providing us “replicated EOBs” that showed an allowed amount different from the actual insurance allowed amount. Obviously this leads to…well you know…LOST REVENUE!
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Recently we were asked by a large national billing service, “why would the medical practice hire you?” Later that week we audited one of their practices and found where the same biller had underpriced the client’s fee schedule to the tune of $12,000. This finding alone almost paid for the entire audit. That EXACTLY is why people hire us.
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The biller missed a fee schedule change (approved to be effective 2/1/13 – system did not capture new charges and this was not identified by biller until January of 2014). This resulted in a settlement amount of $7000 for the client!
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Merged accounts: 

We have found several hospital based practices where they have “merged” accounts. This means two separate patient visits where merged together. The problem is the CPT codes were not merged. Take a look closely at your hospital based billing, your system may be merging accounts and you may be losing money.
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Contact Information
Map of the business location
105 W Jefferson St Blissfield, MI 49228
105 W Jefferson StUSMIBlissfield49228
(866) 407-0763vachettepathology.com
Business Management Consultant, PathologistToday 9:00 am – 5:00 pm
Monday 9:00 am – 5:00 pmTuesday 9:00 am – 5:00 pmWednesday 9:00 am – 5:00 pmThursday 9:00 am – 5:00 pmFriday 9:00 am – 5:00 pmSaturday ClosedSunday Closed
Focused on your bottom line, we are diligent advocates of your payment stream and will oversee your revenues with guaranteed results. More than 500 physicians already know us - You should too!

General Information

In the literal translation, Vachette means "young cow" in French. Figuratively, the name of our company signifies honest answers and steadfast results for your practice.

Vachette Practice Management is a non-biased audit and management firm focused on your bottom line. As diligent advocates of your payment stream we will oversee your revenues with guaranteed results.
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