Preventing revenue leakage during pediatric well-child visits is one of the most complex financial challenges a California clinic can face. Under the state’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program, Medi-Cal outlines clear, comprehensive child health requirements. However, the administrative reality of combining preventative medicine with highly specific vaccine tracking creates a massive […]
Navigating CalAIM Behavioral Health Payment Reform: How to Transition to Fee-for-Service Parity Without Losing Revenue.
California’s CalAIM framework completely retired the exhausting old county cost-reconciliation model. The shift to an Intergovernmental Transfer (IGT) fee-for-service model means faster potential payouts, but it also places the entire administrative burden squarely on your practice’s shoulders. While doctors and behavioral health practitioners went into medicine to treat patients, CalAIM demands they also act as […]
Is Your Practice’s Financial Health Acidic? How the 14 RCM Steps Restore Balance
By: The Partners at pH Claimworks LLPIn the medical world, a slight drop in blood pH can cause cascading health failures. In the business of healthcare, a breakdown in your Revenue Cycle Management (RCM) causes an identical crisis for your bottom line. Many practices focus heavily on the first few steps—patient registration, coding, and initial […]