The stress of first quarter collections does not have to fall entirely on your shoulders. Contract with a third party credit card processing company that will set up financially strapped patients on a payment plan, and increase your cashflow. Bonus: This automatic outsourced system will save you and your patients time.

Thanks to Congress’ rushed effort to shield providers from the scheduled 27.4% rate cut, you will see several changes affecting billing and payments in an emergency update to the 2012 Medicare Physician Fee Schedule.The update alters relative value units (RVUs) for some codes, which guarantees them through Feb. 29, the last effective day of the fee fix. 

More evidence that careless electronic health records (EHR) implementation could lead to denials: A recent Trailblazer Health Enterprises probe review revealed a 40% error rate for new patient Evaluation and Management (E/M) visit documentation, a trend the Dallas-based carrier’s medical director attributes in large part to faulty EHR systems.

It’s best to be prepared in the event that you’re the subject of an investigation by a private payer’s special investigations unit (SIU), which are more serious and have stronger repercussions than a routine payer billing audit (PBN 1/30/12).

In addition to the five scenarios that are holding up provider payments (see related story), the Medical Group Management Association (MGMA) released its letter Feb. 1 to HHS outlining a dozen 5010 transition issues that are clogging claims processing. TIP: You can see MGMA’s full letter to HHS at: www.mgma.com/WorkArea/DownloadAsset.aspx?id=1369699. 

This chart presents four wound care debridement codes and their corresponding denial rates for each year from 2000 until 2010 based on CMS claims data. NOTE: CMS claims data for 97597 was not available before 2004. The data from 2004 was negligible because the code was not in effect until 2005 and all claims that billed 97597 that year were automatically denied.

Can a physician who performs electrocardiograms (EKG) in his or her practice bill the service as part of medical decision-making? Example: One point for ordering the test plus two points for independent visualization to equal three points. Is this considered “double-dipping”?