Look forward to getting more time before a provider’s start date to submit an enrollment, the ability to upload supporting documents and, at long last, the ability to reset your login and password for the Internet-based Provider Enrollment Chain and Ownership System (PECOS). Those practice-friendly changes head a list of upcoming enrollment updates detailed by CMS officials.

Research patient insurance and deductible status before the patient arrives at the office to improve point-of-service deductibles collections required by your payer contracts. Example: Paris (Texas) Orthopedic Clinic checks patient eligibility through a feature in its electronic health records (EHR) as soon as the appointment is made.

Primary care doctors and non-physician practitioners (NPPs) now can bill annual alcohol screening services for Medicare patients, a chance to be paid for the routine questions about alcohol use they already ask patients. The coverage represents another opportunity CMS created for primary care practices to get paid more money, says Jennifer Searfoss, CEO of Searfoss Consulting Group in Annapolis, Md.

Look for more specific codes for vaccine administration and rules about coverage before using 90471 or risk denials. Denials for 90471 (immunization admin, $24.17) are on the rise. In 2010, 42.8% of claims with that code were denied, up from 36.3% in 2009, a Part B News analysis of Medicare data shows (PBN 4/9/12).

This chart shows how many providers from 15 specialties have received the $18,000 Medicare incentive payment for meeting meaningful use for their electronic health records (EHR) from May 2011 to March 2012. The totals below, when multiplied by $18,000, will tell you the total amount CMS has paid each specialty for meeting Medicare’s meaningful use qualifications.

A change to the therapy cap calculation means more work for practices starting Oct. 1.

CMS will count therapy a patient received in a hospital outpatient department toward the cap, set in 2012 at $1,880 for occupational therapy and $1,880 for physical and speech therapies, said Stewart Streimer, director of CMS’s provider billing group during an April 17 call. CMS will not reprocess claims, but, starting Oct. 1 it will recalculate a patient’s services toward the therapy cap amount retroactive to Jan. 1, he said.

Keep an eye on reimbursement policies for physician assistants and nurse practitioners and be ready to work with physician hospital organizations to prevent improper payments and compliance errors.

A private payer that doesn’t credential non-physician practitioners may allow you to bill your NPPs’ services under the physician’s national provider identifier (NPI). The payer might not require a supervising physician to be in the office suite during the service or visit. In this case the practice is able to receive the full fee schedule amount for the NPP’s work and the physician is free to provide other services.

This chart shows the turnover rates last year of two types of non physician practitioners (NPPs) – physician assistants (PAs) and nurse practitioners (NPs). All data comes from the 2011 Physician Retention Survey, a joint effort of the American Medical Group Association (AMGA) and Cejka Search, a health care recruitment company.