MMP’s depth of expertise greatly benefits our clients, and we would like to share with you some of that industry knowledge in the white papers listed below.

Most emergency medicine practices may readily admit that chart reconciliation is an important process to perform in order to prevent lost charges for services provided. Many practices may not be aware that even small miss rate percentages of charges can create large pockets of revenue loss. If implemented and maintained, chart reconciliation allows emergency medicine practices to fill in gaps on lost charges and thus reduce risks for lost revenue. Many emergency medicine practices and third-party billing vendors claim 100 percent chart reconciliation, but there are many pieces to consider before this claim can be made accurately.
Complete White Paper PDF

Since 2004, a series of settlements in class action suits brought principally by the American Medical Association and several large state medical societies against the nation's major managed care companies have—to greater or lesser extents—compelled the health plans to discontinue practices that systematically denied physicians’ reimbursement for services rendered to patients.

A primary complaint by the medical societies was the widespread carrier practice of bundling services to avoid paying physicians for specific CPT codes. “Bundling” in this context refers to the use of claim editing software to review certain procedure codes, e.g. a head laceration from a motor vehicle accident, which may be used with a CPT modifier (the -25 modifier) in conjunction with an “evaluation and management” (E/M) service, e.g., CPT 99283 (emergency department visit involving a limited exam and moderate decision making.)
Complete White Paper PDF

Shifting hospital priorities and continued growth in emergency department volume have led many emergency departments to reconstitute themselves as stand-alone, independent practices.

Making the successful transition from employed physician to independent group requires a clear strategy about how best to organize and staff the enterprise. Most emergency groups today are structured around either independent contractor relationships, physician employees or owner-partner physicians.
Complete White Paper PDF

Hit with improper provider payments that totaled nearly $11 billion in 2007, the Centers for Medicare & Medicaid Services (CMS) is fighting back with an aggressive new program designed to root out fraud, waste and abuse at virtually every level of the Medicare program.

Known as the Medicare Recovery Audit Contractors Program (RAC), the initiative marks a major shift in the way CMS pursues improper provider payments. In the past, Medicare audits have been conducted primarily by fiscal intermediaries or CMS Part B Carriers. With the RACs, however, independent contractors have been enlisted to ferret out improper payments in exchange for a percentage of the dollars recovered.
Complete White Paper PDF

The core competency that defines emergency medicine as a specialty field is centered in our ability to bring to bear critical interventions on patients presenting with organ or life threatening illness and injury. While we routinely handle debilitating ankle sprains, patiently help a young child through his first finger laceration as painlessly as possible, or reassure a middle-aged man that his chest pain is not from a heart attack, our ultimate value to our hospital and our community is our availability and competence in the delivery of complex, skilled intervention to those who would suffer extreme morbidity or mortality were we not present.

Our timely interventions in severe infectious, ischemic, traumatic, surgical and other emergent scenarios obviously have a direct impact on patient outcome. Not so obvious, but only slightly less important in the prevailing climate of rising and scrutinized healthcare costs, what we do well in the first hour of a patient’s presentation can significantly reduce downstream costs for care.
Complete White Paper PDF

Physician groups often find it difficult to carve out time for long-term strategic planning amid the relentless demands and frequent turbulence of day-to-day operations. Yet stepping back to develop solid business objectives has never been more important for medical groups.
Complete White Paper PDF