BC Advantage - 2016 Issue 11

The Impact of Not Knowing: Why Physician Practices Continue to Struggle

In our current environment, medical providers are being inundated with demands from both governmental and commercial payers. With the burden of Comparative Billing Reports (CBRs), Additional Documentation Requests (ADRs), Pre-payment Reviews, Post Payment Reviews, audits by ZPICs, MICs, RACs and Commercial Payers, Denials of medical services for generic reasons such as "Not Medically Necessary," providers oftentimes find themselves scratching their head asking: "Is this really worth it?"   Articles published in the Wall Street journal (August 29, 2014), Forbes (September 11, 2014), The Huffington Post (May 30, 2012), Medical Economics (November 21, 2013), and a host of...

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