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01/17/2011

You can now have hope that your claims from the first half of 2010 will be reprocessed and paid at the higher rates you’re entitled to receive within the next few months. The pay increase for some of these services will approach 7%. CMS officials told your peers during a Jan. 11 conference call that it’s closer to finalizing reprocessing plans. 

01/17/2011

Your practice and patients stand to benefit now that 30 preventive services no longer require copays to be collected or deductibles to be met in 2011 and beyond. To get the most out of this change – part of the health reform law – spread the word about the free services, ensure patients are current on preventive screenings and plan for caveats when screenings turn up problems, experts say.

01/17/2011

Your physician and non-physician providers (NPPs) are getting a reprieve from CMS’s new rule on signatures for clinical lab tests, which would have required a provider signature on every paper order for a test, starting Jan. 1, 2011. NOTE: This is an actual physician signature that can’t be substituted with a rubber stamp or signoff by another staff member, CMS says.

01/17/2011
You must use a new modifier on your claims when a colorectal screening turns diagnostic or therapeutic. Make sure your billing staff knows about the new policy effective Jan. 1, but clue in your A/R department, too. CMS will continue to waive deductible payment for the diagnostic service, but you’ll still be responsible for collecting the patient copay.
01/17/2011

A handful of providers across the country have begun to receive bonus dollars under the federal Electronic Health Record (EHR) Incentive Program, although only those participating in the Medicaid version have been paid, CMS says. Incentive money from the Medicare version of the program will begin to flow in May, an agency official tells Part B News.

01/17/2011

Any pediatricians and oral surgeons in your medical group or practice won’t be deactivated because they haven’t billed Medicare for prolonged periods of time, CMS says. CMS excluded these providers from new regulations that force providers out of the Medicare program when they don’t bill Medicare for 12 consecutive months.

01/17/2011

You still won’t be reimbursed for providing routine magnetic resonance imaging (MRI) tests – no matter how many precautions and safeguards are taken – to your patients with pacemakers, CMS states in a Dec. 1 proposed decision memo. But CMS left the door open to expanding coverage in future years by allowing a clinical trial for such services

01/17/2011
Make sure your electronic health record (EHR) system has the approval of a certification organization before you attest that you met meaningful use standards. Failing to do so will make you ineligible to earn up to $18,000 per physician in EHR bonuses from CMS in 2011. Accrediting organizations have approved 169 ambulatory electronic health record (EHR) systems and modules for ambulatory settings as of Jan. 5. Certifications bodies have also approved 61 EHR products for inpatient facilities.
01/17/2011
Go to www.medicare.gov and review the information CMS has posted about your providers. If the information is wrong, you have a remedy to make corrections. CMS launched a new feature in its physician directory called “Physician Compare.” The site includes contact and address information for offices, the physician’s gender medical specialty, education and residency or clinical training, and whether the provider speaks a foreign language. 
01/17/2011

This chart lists 10 preventive services that saw the highest denial rates in 2009, based on CMS claims data. Assay tests for HIV were the most commonly denied by a hefty margin, and tests for sexually transmitted diseases (STDs) in general represent many of the top-denied services.

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